Published online Jun 6, 2019. doi: 10.12998/wjcc.v7.i11.1330
Peer-review started: January 22, 2019
First decision: March 9, 2019
Revised: April 2, 2019
Accepted: April 18, 2019
Article in press: April 19, 2019
Published online: June 6, 2019
Processing time: 137 Days and 4 Hours
Sarcomatoid hepatocellular carcinoma (SHC) combined with paraneoplastic leukemoid reaction (PLR), which is associated with a poor prognosis, is rarely seen in the clinic. Here, we report the case of a patient in the above situation.
A 75-year-old female patient with a past medical history of hypertension and cerebral infarction paid a hospital visit as a result of right upper quadrant abdominal pain and anorexia for two months. Laboratory examination revealed a white blood cell (WBC) count of 43790/μL, which was then increased up to 77050/μL. In addition, the results of bone marrow examination suggested a leukemoid reaction. Computed tomography (CT) revealed a focal hepatic mass, which was confirmed through pathological examination to be an SHC postoperatively. In addition, the WBC count had fallen to a normal level before she left the hospital. However, the patient died two and a half months after the second hospital admission.
This is a rare case of SHC combined with PLR, both of which have an extremely poor prognosis.
Core tip: Sarcomatoid hepatocellular carcinoma (SHC) is a rare histological subtype of hepatocellular carcinoma (HCC), with largely incompletely described clinical manifestations and outcomes. SHC combined with paraneoplastic leukemoid reaction (PLR), which is defined as reactive leukocytosis exceeding 50000/μL, is associated with a poor prognosis and is rarely seen in the clinic. A surgery or surgery-centered multidisciplinary team may benefit patients in this situation.