title: Leukemoid reaction in cervical cancer: a case report and review of the literature.
abstract: BACKGROUND
  The presentation of a leukemoid reaction in cervical cancers is rare. A leukemoid reaction is defined as leukocytosis associated with a cause outside the bone marrow, with the white blood cell count (WBC) exceeding 50*109/L. Two cervical cancers presenting with leukemoid reactions were previously reported. However, the cancers in these cases were mainly in the advanced stages and had a poor outcome.
  
  
  METHODS
  Here we report a 40-year old patient with clinical stage (FIGO IIA1) cervical squamous carcinoma suffering from vaginal cuff recurrence with a leukemoid reaction two months after laparoscopic radical hysterectomy. The patient suffered from persistent fever and leukocytosis after one month of antibiotic treatment accompanied by rapid growth of the vaginal mass indicated that the leukocytosis could not be caused only by infection. After paclitaxel injection, the WBC count increased to 70.37*109/L. Bone marrow aspirates and biopsy showed left-shift neutrophilia, which confirmed leukemoid reaction. After two courses of paclitaxel and cisplatin treatment, the white blood cell counts decreased to normal, the fever disappeared, and the vaginal mass was reduced dramatically. She achieved completed remission after subsequent chemo-radiation and two additional courses of chemotherapy.
  
  
  CONCLUSIONS
  In our case, leukemoid reaction was related to recurrent cervical carcinoma and sensitive to chemotherapy. To our knowledge, this is the third case to be reported in the literature. Furthermore, this is the only case described that shows an unequivocal correlation between tumor response and leukemoid reaction.
authors.forename: Li
authors.initials: L
authors.lastname: Qing
authors.forename: Tao
authors.initials: T
authors.lastname: Xiang
authors.forename: Zhang
authors.initials: Z
authors.lastname: Guofu
authors.affiliation: Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shen Yang Road 128, Shanghai, China. jingsakura@gmail.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Weiwei
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor; D001706:Biopsy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007955:Leukemoid Reaction / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007958:Leukocyte Count; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor