Paraneoplastic neutrophilic leukocytosis syndrome in a cat with recurrent mammary carcinoma

Abstract

Case summaryA spayed 12-year-old female domestic shorthair cat presented with nodular lesions on the ventral-right thoracic wall after complete mastectomy 4 months previously. The prior diagnosis was tubulopapillary mammary carcinoma with axillary lymph node metastasis, and a recurrence was confirmed. A gradual and sequential increase in the total number of leukocytes with severe neutrophilia (95.632/µl) developed over the course of the illness, along with an increase in the size of the recurrent mass. The severe leukocytosis did not show any response to antibiotic therapy, and no evidence of infection was observed. Bone marrow cytology confirmed hypercellularity in the myeloid cell lineage. Based on these findings, paraneoplastic neutrophilic leukocytosis syndrome was suspected. An incisional biopsy of the recurrent mass was consistent with recurrent tubulopapillary mammary carcinoma. Malignant epithelial cells stained positive upon immunohistochemistry for granulocyte–macrophage colony-stimulating factor, cytokeratin and vimentin. After the final diagnosis of paraneoplastic neutrophilic leukocytosis syndrome, the cat was euthanized at the owner’s request.Relevance and novel informationThis is a novel case of paraneoplastic leukocytosis syndrome associated with mammary carcinoma in a cat. Although there are some reports describing paraneoplastic leukocytosis in cats, the relationship between this syndrome and feline mammary tumors has not been described.

Evaluation of Hemostatic Parameters in Tumor-Bearing Dogs

“…Studies in humans have shown that carcinoma-associated thrombocytosis may be related to the tumor production of granulocytemacrophage colony stimulating factors (GM-CSF) and IL-6 [3,36]. Our research group previously reported a paraneoplastic leukocytosis in a cat with mammary gland carcinoma expressing GM-CSF [12].…”

Probable paraneoplastic leukocytosis in a dog with a gastrointestinal stromal tumor

“…Paraneoplastic leukocytosis is a severe neutrophilia accompanied by a left shift (often termed a leukemoid response) caused by tumor cell secretion of a substance that stimulates bone marrow maturation and release of white blood cells. 9 In the dog and cat, tumors causing an established (defined as secretion of a functional peptide or hormone + resolution of the leukocytosis following tumor removal) or probable (defined as resolution of the leukocytosis following tumor removal) paraneoplastic leukocytosis include pulmonary carcinoma (papillary, adenocarcinoma, squamous cell), [10][11][12] rectal polyp, 13,14 renal carcinoma (tubular, transitional cell), [15][16][17][18] mammary carcinoma, 19 and dermal tubular adenocarcinoma. 12 release from the bone marrow.…”

A chronic, non‐healing, ulcerative and proliferative lesion revealed to be squamous cell carcinoma in a camel

“…Recurrence, regional malignancy, local invasion and paraneoplastic syndromes are known consequences associated with numerous types of neoplasia. [17][18][19][20][30][31][32] Applying knowledge from literature published from their native environments while including their current environmental risk factors, such as age and sunlight exposure, are all important aspects of a camel's veterinary exam. Performing a complete physical exam, gait evaluation, diagnostic bloodwork and taking deep biopsy samples can help diagnose neoplasia like SCC early, increasing treatment options and potentially improving prognosis.…”

“…Other potential causes of the bone marrow erythroid hypoplasia include chronic infection or inflammation as seen in this case (though unlikely as the fibrinogen was within normal limits). 29 There is also the possibility it had a paraneoplastic neutrophilic leukocytosis  of  developing, which has been described in dogs 30 and cats 31 because the patient's white blood cell count, specifically neutrophils, increased fourfold before to after operation in the face of antimicrobial therapy. Another potential cause of the neutrophilic leukocytosis includes an increase after operation from a surgical site infection, which would cause local inflammation to the area of the wound, or a mild aspiration pneumonia from postoperative regurgitation, following extubation of the endotracheal tube after surgery.…”