A patient with breast cancer without splenectomy associating with idiopathic thrombocytopenic purpura (ITP) was operated on treating with high-dose immunoglobulin therapy (400mg/kg/day) and fresh platelets (10 units/day) for 3 consecutive days pre- and postoperatively. Modified radical mas-tectomy with regional lymph node dissection (R1) was successfully performed without abnormal bleeding during the surgery. Postoperative course was uneventful without serious complications and platelet count was kept at the level around 10, 000/mm3 during the perioperative period.
High-dose immunoglobulin therapy with fresh platelet infusion therapy, which can increase platelet count safely and certainly in a short time, may be most appropriate for ITP cases combined with a solid cancer without splenectomy, whereas further consideration regarding the treatment period and dosage may be needed due to the expensiveness, uncontinuanceness and dose-dependency of the drug.