Paraneoplastic Neutrophilic Leukocytosis in a Rare Variant of Papillary Thyroid Carcinoma: A Diagnostic Dilemma with Fatal Outcome
Keywords:
Papillary thyroid carcinoma, Anaplastic thyroid carcinoma, Leukocytosis, Paraneoplastic syndrome, leukamoid reaction, GM-CSF, IL-6.Abstract
Background: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, typically associated with a favorable prognosis. However, rare histological variants and unusual clinical presentations can pose significant diagnostic challenges. Paraneoplastic neutrophilic leukocytosis is an uncommon manifestation in thyroid malignancy and may mimic infectious or inflammatory conditions, leading to diagnostic confusion.
Case Description: We report a case of an adult male patient with an advanced, rare variant of papillary thyroid carcinoma who presented with persistent and marked neutrophilic leukocytosis. Despite extensive evaluation, no evidence of infection or hematologic disorder was identified. Histopathological examination confirmed a rare aggressive variant of PTC. The paraneoplastic leukocytosis was attributed to tumor- related cytokine production. The disease progressed rapidly, culminating in a fatal outcome despite supportive management.
Discussion: Paraneoplastic leukocytosis is a rare but important clinical entity in thyroid malignancies, particularly in aggressive variants. It results from tumor secretion of granulocyte colony-stimulating factors and often indicates advanced disease with poor prognosis. Recognition of this paraneoplastic phenomenon is essential to avoid unnecessary antimicrobial therapy and to anticipate rapid disease progression.
Conclusion: This case highlights the diagnostic dilemma posed by paraneoplastic neutrophilic leukocytosis in rare variants of papillary thyroid carcinoma. Awareness of this uncommon presentation is crucial for timely diagnosis, appropriate management, and prognostication.
Bangladesh J Otorhinolaryngol 2026; 32(1): 45-52
0
Downloads
Published
How to Cite
Issue
Section
License
Manuscripts submitted for publication in the Bangladesh Journal of Otorhinolaryngology must not have been previously submitted or published. Accepted papers become the permanent property of the Bangladesh Journal of Otorhinolaryngology. By submitting a manuscript, the authors(s) agree that copyrights for their articles are automatically transferred to Bangladesh Journal of Otorhinolaryngology, if and when the articles are accepted for publication.
The use, in this journal, of registered trade names, trade marks, etc. without special acknowledgement does not imply that such names, as defined by the relevant protection laws, be regarded as unprotected, and, thus, free for general use.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
