Severe, refractory paraneoplastic aplastic anemia secondary to primary peritoneal carcinoma: a case report
Year: 2025
Type: article
Study design: Case Report
Abstract: • This is the first case reported of paraneoplastic aplastic anemia secondary to primary peritoneal carcinoma. • Severe pancytopenia complicated surgery, management of post-operative complications, and chemotherapy selection and duration. • This case highlights the need for multi-disciplinary care in complex gynecologic paraneoplastic syndromes. Acquired aplastic anemia may rarely present as a paraneoplastic syndrome primarily associated with thymomas and lymphoma. We describe the first case, to our knowledge, of paraneoplastic aplastic anemia secondary to high-grade serous primary peritoneal carcinoma (PPC). A 63-year-old female with a pathogenic germline BRCA1 mutation was found to have pancytopenia at the time of PPC diagnosis. She received granulocyte colony-stimulating factor (GCSF), thrombopoietin (TPO) mimetic, and immunosuppressive therapy with prednisone prior to primary cytoreductive surgery to no apparent gross residual disease. Stage IIIC2 PPC was confirmed on pathology. Her post-operative course was complicated by a large bowel anastomotic leak and sepsis in the setting of neutropenia. Persistent pancytopenia led to the diagnosis of severe aplastic anemia on serial bone marrow biopsies. She was treated with anti-thymocyte globulin (ATG) and cyclosporine and subsequently received adjuvant chemotherapy with weekly cisplatin and subsequent addition of weekly paclitaxel, resulting in reduction in her serum Cancer Antigen-125 (CA-125) and no radiographic evidence of disease. Despite initial response, her clinical deterioration and her decision to forego further cancer- or aplastic anemia-directed therapy resulted in transition to home hospice care, and she was discharged 119 days after admission. This case report highlights the importance of multi-disciplinary collaboration to manage the medical complexities of paraneoplastic aplastic anemia secondary to a gynecologic malignancy.
Source: Gynecologic Oncology Reports
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $930
OpenAlex ID: W4415900028