Neutrophilic leukocytosis above 50 × 109/l exclude leukemia, defines a leukemoid reaction (LR). It is associated with several diseases. Although it simulates leukemia, most of the causes are benign. Tumor-related LR is more common. It is associated with ranulocyte colony-stimulating factor (G-CSF) secreted by the tumor cells. A 38-year-old woman, presented with advanced breast cancer and leukocytosis (79.9 × 103/uL) was found. After completion of MRM, the condition of leukocytosis subsided. Two months later, tumor local relapse was found and white blood cells (WBC) rose again. After completion of wide excision, the condition of leukocytosis subsided again. We think this case was associated with leukemoid reaction.
The leukemoid reaction (LR) is a potential marker for malignant behaviour and poor prognosis in advanced tumours. This is kind of paraneoplastic syndrome. Most paraneoplastic syndromes appear only during the late stages of malignancy when the diagnosis has long been established, but sometimes may be an early sign of the malignancy. However, it’s rarely found in cases of breast cancer. Herein, we reported a case of advanced breast cancer related LR and the LR disappeared after disease controlled.
A 38-year-old woman, presented with progressive lump in right breast. Physical examination showed a palpable huge mass in the right breast (
The WBC count more than 50 × 109/l associated with a cause outside the bone marrow is termed as leukemoid reaction (LR) [
Our patient was a case of huge breast cancer (T4 lesion) and leukocytosis was found. Every time she underwent chemotherapy, the WBC counts dropped. Nimieri HS et al. reported the good response of a LR to chemotherapy
and local radiotherapy in a patient diagnosed with cervical cancer [
This case supports the theory that the tumor cells produce the G-CSF, then result in marked leukocytosis. The LR will be disappeared after well control of tumor cells or primary lesion. Leukocytosis may be as a hint of tumor relapse.