Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations
Paraneoplastic leukemoid reaction occurs secondary to cytokine-secreting tumors or cancers with high tumor burden. We report a case of extreme leukocytosis in a 58-year-old man presenting with a clavicular mass. Biopsy revealed a high-grade, non–small cell carcinoma of unknown origin, and genetic st...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2023-11-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2023.0502 |
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| author | Kim L. Tran Seema R. Walvekar Brian C. Boulmay Sarah W. Lungaro Jasmine L. Taylor |
| author_facet | Kim L. Tran Seema R. Walvekar Brian C. Boulmay Sarah W. Lungaro Jasmine L. Taylor |
| author_sort | Kim L. Tran |
| collection | DOAJ |
| description | Paraneoplastic leukemoid reaction occurs secondary to cytokine-secreting tumors or cancers with high tumor burden. We report a case of extreme leukocytosis in a 58-year-old man presenting with a clavicular mass. Biopsy revealed a high-grade, non–small cell carcinoma of unknown origin, and genetic studies identified a lung adenocarcinoma with triple mutations in STK11, KRAS, and TP53 along with programmed death-ligand 1 positivity. Leukocytosis persisted despite treatment, so the diagnosis of paraneoplastic leukemoid reaction was made. Treatment of underlying malignancy is imperative in management, but this case was complicated by tumor mutations that rendered the most optimal treatments less effective. |
| format | Article |
| id | doaj-art-d45f7ab2a84545f7b41d7bc95bf04f0f |
| institution | OA Journals |
| issn | 2767-7664 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-d45f7ab2a84545f7b41d7bc95bf04f0f2025-08-20T02:17:33ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642023-11-0121110.7326/aimcc.2023.0502Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-MutationsKim L. Tran0Seema R. Walvekar1Brian C. Boulmay2Sarah W. Lungaro3Jasmine L. Taylor41Louisiana State University Health Sciences Center, New Orleans, Louisiana1Louisiana State University Health Sciences Center, New Orleans, Louisiana1Louisiana State University Health Sciences Center, New Orleans, Louisiana1Louisiana State University Health Sciences Center, New Orleans, Louisiana2Hospital of the University of Pennsylvania, Philadelphia, PennsylvaniaParaneoplastic leukemoid reaction occurs secondary to cytokine-secreting tumors or cancers with high tumor burden. We report a case of extreme leukocytosis in a 58-year-old man presenting with a clavicular mass. Biopsy revealed a high-grade, non–small cell carcinoma of unknown origin, and genetic studies identified a lung adenocarcinoma with triple mutations in STK11, KRAS, and TP53 along with programmed death-ligand 1 positivity. Leukocytosis persisted despite treatment, so the diagnosis of paraneoplastic leukemoid reaction was made. Treatment of underlying malignancy is imperative in management, but this case was complicated by tumor mutations that rendered the most optimal treatments less effective.https://www.acpjournals.org/doi/10.7326/aimcc.2023.0502 |
| spellingShingle | Kim L. Tran Seema R. Walvekar Brian C. Boulmay Sarah W. Lungaro Jasmine L. Taylor Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations Annals of Internal Medicine: Clinical Cases |
| title | Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations |
| title_full | Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations |
| title_fullStr | Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations |
| title_full_unstemmed | Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations |
| title_short | Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations |
| title_sort | paraneoplastic leukemoid reaction in high grade lung adenocarcinoma complicated by triple co mutations |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2023.0502 |
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