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The occurrence of
multiple primary cancers is rare; it can be missed as a disease progression.
The etiology remains controversial. We report a case of a 55-year-old female
with metastatic renal cell carcinoma treated with sutent followed by left sided
nephrectomy. Follow-up CT showed increase in the size of the right axillary
lymph nodes which was proven after biopsy to be metastatic adenocarcinoma of
the breast. Any suspicious disease progression in a single site not
compatible with disease history should be biopsied for confirmation. The
relationship between renal cell carcinoma and breast cancer is still unclear,
and more case reports are required to determine this relationship.
reactions in cancer are rare and associated with a poor prognosis. The
mechanism driving paraneoplastic leukemoid reactions appears to be
gain-of-function granulocyte-colony stimulating factor (G-CSF) secretion by
tumour cells. Case Presentation: A 57-year-old male smoker presented with a
one-year history of painless frank hematuria and three kilograms weight loss.
Cystoscopy revealed a high-grade urothelial carcinoma with sarcomatoid
differentiation. The patient was treated by radical cystoprostatectomy,
bilateral pelvic lymph node dissection and formation of an ileal conduit. In
the absence of bone marrow infiltrations, recurrence of the urothelial
carcinoma three months later was associated with a paraneoplastic leukemoid reaction with a white blood cell count peaking at 82.62 × 109/l. Unfortunately, his condition continued to
deteriorate and he died shortly thereafter. Conclusion: Monitoring of white
blood cell counts in paraneoplastic leukemoid reactions can be a useful
indicator of response of the malignancy to chemotherapy or radiotherapy and an
indication of relapse after treatment. Paraneoplastic leukemoid reactions are
caused by G-CSF secretion by tumour cells and are associated with a poor
prognosis. Whether G-CSF signaling plays a role in the aggressive nature of
these cancers is currently unknown.