• Joana Branco Ferrão, Mariana Pereira Sardinha, and Eduardo Dutra.
• Department of Internal Medicine, Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal. Electronic address: joanabrancoferrao@gmail.com.
• Am. J. Med. Sci. 2021 Aug 1; 362 (2): 211-214.

AbstractHematological paraneoplastic syndromes are fairly uncommon. While mild leukocytosis in solid tumors is well reported, white blood cell (WBC) count over 50,000 u/L, described as paraneoplastic leukemoid reaction (PLR), is not. Indeed, when found, it is usually associated with a higher burden of disease, tumor activity and worse clinical outcomes. We report the case of a challenging and burdensome diagnosis of a presumptive hematological paraneoplastic syndrome in a patient with a locally advanced lung cancer admitted in the Internal Medicine ward. After the end of chemotherapy, clinical and laboratory benefit was observed; however, the aggressive course of the disease became clear, with progression and downhill course that was unresponsive to treatment.Copyright © 2021 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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