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Leukemoid reaction: a rare paraneoplastic event in a case of advanced penile cancer and its management
  1. Amit Kumar Mishra,
  2. Ketan Mehra,
  3. Ramanitharan Manikandan and
  4. Lalgudi Narayanan Dorairajan
  1. Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Ketan Mehra, drketanmehra{at}


Leukemoid reaction is a paraneoplastic phenomenon associated predominantly with solid tumours. Malignancies presenting with leukemoid reaction have a grave prognosis. It is defined as persistent neutrophil count greater than 50×103 cells/µL. We report a case of leukemoid reaction in a patient with metastatic penile cancer. A 60-year-old man with partial penectomy status for squamous cell carcinoma of penis on neoadjuvant chemotherapy, presented with left fungating inguinal lymphadenopathy and total leucocyte count 96×103 cells/µL and hypercalcaemia. Leucocytealkaline phosphatase (LAP) score was excessively elevated. The patient underwent left ilioinguinal block dissection along with vastus lateralis flap for defect reconstruction. Postoperatively, the neutrophil counts and serum calcium level normalised. The patient improved clinically and was discharged.

  • urological cancer
  • urological surgery
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  • Contributors AKM: drafting the work or revising it critically for important intellectual content. KM: ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. RM: final approval of the version published and agreement to be accountable for all aspects of the work. LND: design of the work, acquisition and analysis data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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