Leukemoid reaction: a rare paraneoplastic event in a case of advanced penile cancer and its management.

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.

BMJ case reports. 2019 Aug 12*** epublish ***

Amit Kumar Mishra, Ketan Mehra, Ramanitharan Manikandan, Lalgudi Narayanan Dorairajan

Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.