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Case Reports
. 2014 Apr 19:12:100.
doi: 10.1186/1477-7819-12-100.

Leukemoid reaction in sarcomatoid renal cell carcinoma: a two-case report

Weiping Huang, Feng Wang, Yeping Li, Feifei Duan, Zhixian Yu  1
Affiliations
Case Reports

Leukemoid reaction in sarcomatoid renal cell carcinoma: a two-case report

Weiping Huang et al. World J Surg Oncol. .

Abstract

Leukemoid reaction is defined as reactive leukocytosis exceeding 40 × 10⁹/l, with a significant increase in early neutrophil precursors, and can be a paraneoplastic manifestation of various malignant tumors. Leukemoid reaction is a sign for poor prognosis in solid tumors so is sarcomatoid renal cell carcinoma (SRCC) when compared to more differentiated histologies. Here, we are reporting two cases of leukemoid reaction after radical nephrectomy, both of which were diagnosed as SRCC pathologically. The operations were successful: no complications were observed and the patients were discharged in good condition. However, a few weeks later, the white blood cell (WBC) count gradually increased. Even though routine management was done immediately, the count was still elevating. A diagnosis of a leukemoid reaction was established and both of them died shortly thereafter. Due to the poor prognosis of most patients with malignant leukemoid reaction, leukemoid reaction may be a predictor of prognosis in patients with SRCC, but more data are needed.

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Figures

Figure 1
Figure 1
Scans of the left kidney mass. A. CT scan: a mass measuring 8 × 10 cm in the left kidney. B. MR: A giant abnorminal signal in the right kidney, measuring 9 × 10 cm. Hydronephrosis existed.
Figure 2
Figure 2
Pathological examination of sarcomatoid renal cell carcinoma cells. A. Sarcomatoid renal cell carcinoma was confirmed by the pathological examination. B. Sarcomatoid renal cell carcinoma was confirmed by the pathological examination.
Figure 3
Figure 3
WBC count graphs showing WBC count was record down when patients were admitted to hospital. A. WBC gradually increased postoperatively. Δ represents the first day patient underwent radical nephrectomy. ○ represents the day patient was discharged from hospital. B. WBC count gradually increased postoperatively. Δ represents the first day the patient underwent radical nephrectomy. ○ represents the day the patient was discharged from hospital. L, liter; WBC, white blood count.
See this image and copyright information in PMC

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