A case of leukemoid reaction in a patient with sarcomatous hepatocellular carcinoma

A leukemoid reaction is defined as reactive leukocytosis exceeding 50,000/mm(3), with a significant increase in early neutrophil precursors, and can be a paraneoplastic manifestation of various malignant tumors. A 71-year-old male patient complained of decreased appetite, fatigue, and abdominal fullness. He had a palpable, firm liver, and laboratory investigations suggested leukemoid reaction. Liver dynamic computed tomography revealed a hypervascular mass, and an ultrasound-guided fine-needle aspiration of the mass confirmed hepatocellular carcinoma (HCC) with a sarcomatoid component. The leukocyte count of the patient had increased to 147,800/mm(3), and he died 10 days after admission. This is a rare case of leukemoid reaction in a patient with sarcomatous HCC.