Hyperleukocytosis in Solid Tumors: a Rare Paraneoplastic Syndrome Associated with Poor Prognosis

• Main Author: Ferrão, J
• Publication Date: 2021
• Other Authors: Sardinha, M, Dutra, E
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://hdl.handle.net/10400.17/4641
• topic: CHLC MED; HSAC ONC; CHLC ANPAT; Antineoplastic Agents / therapeutic use; Carcinoma / complications*; Carcinoma / drug therapy; Fatal Outcome; Humans; Male; Middle Aged; Lung Neoplasms / complications*; Lung Neoplasms / drug therapy; Paraneoplastic Syndromes / diagnosis*; Paraneoplastic Syndromes / pathology*; Prognosis

Hematological paraneoplastic syndromes are fairly uncommon. While mild leukocytosis in solid tumors is well reported, white blood cell (WBC) count over 50,000 u/L, described as paraneoplastic leukemoid reaction (PLR), is not. Indeed, when found, it is usually associated with a higher burden of disease, tumor activity and worse clinical outcomes. We report the case of a challenging and burdensome diagnosis of a presumptive hematological paraneoplastic syndrome in a patient with a locally advanced lung cancer admitted in the Internal Medicine ward. After the end of chemotherapy, clinical and laboratory benefit was observed; however, the aggressive course of the disease became clear, with progression and downhill course that was unresponsive to treatment.