Hu Bo, Sang Xin-Ting, Yang Xiao-Bo
Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
World J Clin Cases. 2019 Jun 6;7(11):1330-1336. doi: 10.12998/wjcc.v7.i11.1330.
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.
肉瘤样肝细胞癌（SHC）合并副肿瘤性类白血病反应（PLR）临床罕见，且预后较差。在此，我们报告一例处于上述情况的患者。
一名75岁女性患者，既往有高血压和脑梗死病史，因右上腹疼痛和食欲不振两个月前来就诊。实验室检查显示白细胞（WBC）计数为43790/μL，随后升至77050/μL。此外，骨髓检查结果提示类白血病反应。计算机断层扫描（CT）显示肝脏有一个局灶性肿块，术后经病理检查确诊为SHC。另外，患者出院前白细胞计数已降至正常水平。然而，患者在第二次入院两个半月后死亡。
这是一例罕见的SHC合并PLR病例，两者预后均极差。
