A Multimodal Strategy for Perioperative Reactive Thrombocytosis in Gynaecologic Cancer Surgery - A Case Report

Reactive thrombocytosis, defined as platelet count >450 × 10 3 /µL, can pose perioperative thrombotic and bleeding risk. We present the case of a 47-year-old woman with bilateral ovarian masses, uterine fibroids and pelvic abscess, whose platelet count peaked at 750 × 10 3 /µL. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy under general anaesthesia, employing pre- and post-operative enoxaparin, mechanical prophylaxis, adequate hydration and multimodal analgesia while avoiding neuraxial techniques. Post-operative recovery was uneventful; platelet count normalised by day 7. This case underscores the necessity of individualised, guideline‐driven thromboprophylaxis and multidisciplinary collaboration to optimise the outcomes in reactive thrombocytosis.