Hyperleukocytosis in Solid tumors: A Rare Paraneoplastic Syndrome Associated with Poor Prognosis

Ferrão, Joana Branco; Sardinha, M.; Dutra, Eduardo

doi:10.1016/j.amjms.2021.01.027

Cited by 3 publications

(2 citation statements)

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“…The diagnosis is further supported by resolution of WBC elevations as the tumor burden decreases and is thought to be due to tumor secretion of growth factors or cytokines (8, 9, 11). Often confused with hematologic malignancy and a rare entity, PRL is a diagnostic challenge and is seen as a marker of extremely poor prognosis, associated with increased tumor burden and rapid growth (11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

“…A rare syndrome of extreme hyperleukocytosis, paraneoplastic leukemoid reaction (PLR), involves WBC elevations of greater than 50 k/ul in the absence of hematologic malignancy (8-10). Solid tumors in the lung and gastrointestinal have been most commonly associated with PLR, with sarcomatoid carcinoma representing a histological subtype frequently associated with this syndrome (8,9,11).…”

Section: Introductionmentioning

confidence: 99%

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Ovarian Sarcomatoid Carcinoma Presenting with Paraneoplastic Leukemoid Reaction: Case Report

Sainsbury,

Watts,

Hinchman-Dominguez

et al. 2023

Preprint

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Background: Sarcomatoid carcinoma is an aggressive, rare malignancy that can arise as mural nodules in the presence of other primary ovarian malignancies. Associated with sarcomatoid carcinomas of other organs, paraneoplastic leukemoid reaction (PRL) is a rare syndrome of extreme hyperleukocytosis, usually greater than 50 k/ul, that arises in the absence of a primary hematologic malignancy and characteristically resolves following tumor removal. Case Presentation: A 57-year-old female presented with vague gastrointestinal symptoms and was incidentally found to have white blood cell (WBC) of 56.4 k/ul, with a negative work-up for hematologic malignancy. Abdominal CT imaging demonstrated a large abdominal mass and biopsy confirmed a diagnosis of sarcomatoid carcinoma, clinically favored to be of ovarian origin. Treatment consisted of surgical resection of the large (32 x 30 x 17 cm) mass, left salpingo-oophorectomy, and radical small bowel resection. Notably, the patient’s WBC count fell from 175 k/ul, on the morning of surgery, to 17.3 k/ul, days after tumor resection. Conclusion: We report a rare case of sarcomatoid carcinoma of probable ovarian origin, presenting with extreme leukocytosis and characteristic behavior of PRL. Sarcomatoid carcinoma and PRL are both, individually, associated with a poor prognosis. Accurate diagnosis is essential to ensure minimal delay in initiating treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%