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A case of anaplastic carcinoma of the pancreas producing granulocyte-colony stimulating factor
Authors:Toru Murata  Masaki Terasaki  Kenji Sakaguchi  Masayuki Okubo  Yasuyuki Fukami  Kazumi Nishimae  Yasuhiko Kitayama  Shoji Hoshi
Affiliation:(1) Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka 422-8527, Japan;(2) Department of Pathology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan
Abstract:
We report a case of anaplastic carcinoma of the pancreas with production of granulocyte-colony stimulating factor (G-CSF) in a 59-year-old male. He was referred to our hospital with a chief complaint of epigastralgia and suffered from leukocytosis. Differential diagnosis included pancreatic tumors and submucosal tumor of the stomach, but definite preoperative diagnosis could not be made. He underwent distal pancreactomy, total gastrectomy with Roux-en-Y reconstruction and splenectomy. He recovered uneventfully postoperatively and was discharged from hospital on the 14th postoperative day. Histological examination showed anaplastic carcinoma of the pancreas. Since the peripheral leukocyte count was sharply decreased after the operation, we suspected the tumor would be producing G-CSF. Then immunohistochemistry showed a positive stain in the tumor. Therefore, we diagnosed the tumor as anaplastic carcinoma of the pancreas producing G-CSF. Three months after the resection, local recurrence was detected by abdominal computed tomography. The patient died of hemorrhagic shock due to tumor invasion of the intestine 8 months after the operation.
Keywords:Anaplastic carcinoma  Pancreas  Granulocyte-colony stimulating factor
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