Undifferentiated ovarian carcinoma associated with leukemoid reaction

Exceptionally excess leukocytosis or leukemoid reaction may develop in association with carcinomas of the lung and stomach. The authors describe a 72-year-old lady with FIGO stage III ovarian undifferentiated carcinoma who presented with fever and abdominal pain. Her serial WBC counts were up to 143,000/microl with elevated leukocyte alkaline phosphatase score. She received extended total hysterectomy, left salpingo-oophorectomy, and de-bulking of the retroperitoneal mass. Her left ovarian cancer was composed of diffuse sheets of large undifferentiated cells that were immunoreactive for cytokeratin, confirming the epithelial nature. She passed away one week after operation and five weeks after presentation without autopsy. This is the first report of ovarian cancer associated with leukemoid reaction in the English literature.