Tumor fever, paraneoplastic leukocytosis and necrotic liver metastases: a triad worth remembering

Arriving at the diagnosis of tumor fever may prove difficult for the clinician and should always be based upon investigations that exclude other potential causes of fever. Timely recognition of this entity is essential for the effective delivery of care to cancer patients. In solid malignancies, tumor fever is commonly associated with rapidly progressive metastatic disease and a limited survival. Liver metastases are present in many of these patients and some of them may display significant systemic inflammation. We report two unique patients with adenocarcinoma of the lung associated with tumor fever, necrotic liver metastases and granulocyte-colony stimulating factor (G-CSF) driven leukocytosis.