Hu B, Sang XT, Yang XB. Paraneoplastic leukemoid reaction in a patient with sarcomatoid hepatocellular carcinoma: A case report. World J Clin Cases 2019; 7(11): 1330-1336 [PMID: 31236397 DOI: 10.12998/wjcc.v7.i11.1330]
Corresponding Author of This Article
Xin-Ting Sang, MD, Director, Professor, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Wangfujing, Beijing 100730, China. sangxt@pumch.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 6, 2019; 7(11): 1330-1336 Published online Jun 6, 2019. doi: 10.12998/wjcc.v7.i11.1330
Paraneoplastic leukemoid reaction in a patient with sarcomatoid hepatocellular carcinoma: A case report
Bo Hu, Xin-Ting Sang, Xiao-Bo Yang
Bo Hu, Xin-Ting Sang, Xiao-Bo Yang, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Author contributions: Hu B collected the patient’s clinical data and wrote the paper; Sang XT and Yang XB analyzed the data and designed the report.
Informed consent statement: Consent was obtained from the patient at the time of investigations, but not at the time of writing this case report.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-Ting Sang, MD, Director, Professor, Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Wangfujing, Beijing 100730, China. sangxt@pumch.cn
Telephone: +86-010-69152836 Fax: +86-010-69156043
Received: January 21, 2019 Peer-review started: January 22, 2019 First decision: March 9, 2019 Revised: April 2, 2019 Accepted: April 18, 2019 Article in press: April 19, 2019 Published online: June 6, 2019 Processing time: 137 Days and 4 Hours
Abstract
BACKGROUND
Sarcomatoid hepatocellular carcinoma (SHC) combined with paraneoplastic leukemoid reaction (PLR), which is associated with a poor prognosis, is rarely seen in the clinic. Here, we report the case of a patient in the above situation.
CASE SUMMARY
A 75-year-old female patient with a past medical history of hypertension and cerebral infarction paid a hospital visit as a result of right upper quadrant abdominal pain and anorexia for two months. Laboratory examination revealed a white blood cell (WBC) count of 43790/μL, which was then increased up to 77050/μL. In addition, the results of bone marrow examination suggested a leukemoid reaction. Computed tomography (CT) revealed a focal hepatic mass, which was confirmed through pathological examination to be an SHC postoperatively. In addition, the WBC count had fallen to a normal level before she left the hospital. However, the patient died two and a half months after the second hospital admission.
CONCLUSION
This is a rare case of SHC combined with PLR, both of which have an extremely poor prognosis.
Core tip: Sarcomatoid hepatocellular carcinoma (SHC) is a rare histological subtype of hepatocellular carcinoma (HCC), with largely incompletely described clinical manifestations and outcomes. SHC combined with paraneoplastic leukemoid reaction (PLR), which is defined as reactive leukocytosis exceeding 50000/μL, is associated with a poor prognosis and is rarely seen in the clinic. A surgery or surgery-centered multidisciplinary team may benefit patients in this situation.
