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[A case of bladder carcinoma representing leukemoid reaction]
R Otomo1, S Yamashiro, O Nishizawa
1Department of Urology, Akita University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. the Japanese Journal of Urology
|February 1, 1993
Summary
This study details a rare case of severe leukocytosis, a leukemoid reaction, caused by advanced bladder cancer. Treatment involving chemoembolization temporarily normalized white blood cell counts, highlighting the tumor
Area of Science:
- Oncology
- Hematology
Background:
- Locally invasive bladder carcinoma (pT4 pNo Mo) presented with marked leukocytosis (64,900/mm3) without inflammatory signs.
- Grade 3 transitional cell carcinoma (TCC) involved the prostate; imaging ruled out distant metastasis.
- Normal serum calcium and negative bone marrow biopsy excluded leukemia, suggesting a leukemoid reaction.
Observation:
- Preoperative chemoembolization with mitomycin C and cisplatin reduced tumor size and normalized leukocyte count (8,200/mm3).
- Post-surgery, leukocytosis recurred (51,300/mm3) with intrapelvic tumor recurrence.
- Elevated serum granulocyte colony-stimulating factor (G-CSF) levels (130.9 pg/ml) were detected.
Findings:
- The patient's leukocytosis is strongly indicative of a paraneoplastic leukemoid reaction secondary to bladder carcinoma.
- The bladder tumor likely releases G-CSF, driving the excessive white blood cell production.
- This case adds to the ten previously reported instances of bladder tumors causing leukemoid reactions.
Implications:
- Leukemoid reactions can be a significant paraneoplastic manifestation of bladder cancer.
- Monitoring G-CSF levels may aid in diagnosing and managing such cases.
- Understanding this association is crucial for comprehensive cancer patient care and treatment strategies.