Lobectomy for lung cancer in a myelodysplastic syndrome patient with decreasing platelet aggregation: report of a case

J Cardiothorac Surg. 2018 Jul 24;13(1):89. doi: 10.1186/s13019-018-0777-7.

Abstract

Background: Myelodysplastic syndromes (MDS) are clonal stem cell disorders of the bone marrow. Most patients with MDS have a high risk of bleeding. Thrombocytopenia and defective platelet aggregation contribute to bleeding. We report a surgical case of a patient with lung cancer concomitant with MDS.

Case presentation: A 72-year-old man presented to our hospital because of an abnormal shadow on chest x-ray suggesting a primary lung cancer. A peripheral blood smear examination found giant platelets without thrombocytopenia. He was diagnosed with MDS by bone marrow biopsy, and showed defective platelet aggregation despite a normal bleeding time. The patient underwent left lower lobectomy and transfusion of platelets because of chest wall bleeding.

Conclusions: We demonstrated that ordering platelet preparations might be desirable for an MDS patient with defective platelet aggregation who will undergo surgery, even for a normal platelet count and bleeding time.

Keywords: Lung cancer; Myelodysplastic syndrome; Platelet aggregation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Coagulation Disorders / complications*
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / surgery*
  • Male
  • Myelodysplastic Syndromes / complications*
  • Myelodysplastic Syndromes / physiopathology
  • Platelet Aggregation
  • Platelet Transfusion*
  • Pneumonectomy* / adverse effects
  • Preoperative Care*
  • Thrombocytopenia / complications
  • Tomography, X-Ray Computed