Gastric adenosquamous carcinoma producing granulocyte-colony stimulating factor |
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Authors: | Kazuya Endo Shunji Kohnoe Takeshi Okamura Masaru Haraguchi Eisuke Adachi Yasushi Toh Hideo Baba Yoshihiko Maehara |
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Affiliation: | (1) Department of General Surgery, Fukuoka Dental College Hospital, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan;(2) Department of Gastroenterologic Surgery, National Kyushu Cancer Center, Fukuoka, Japan;(3) Department of General Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan |
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Abstract: | We report a case of adenosquamous carcinoma of the stomach that produced granulocyte-colony stimulating factor (G-CSF). The patient, who had an admission diagnosis of advanced gastric cancer, had marked leukocytosis without evidence of infection. After leukemia and metastatic leukemoid reaction were excluded by bone marrow examination, a G-CSF-producing cancer was suspected as the cause of the abnormally elevated serum G-CSF level. The resected stomach tumor was histologically diagnosed as adenosquamous carcinoma; positive expression of G-CSF by tumor cells was shown with immunohistochemical detection, which confirmed the preoperative diagnosis. Recurrent disease in the liver and lymph nodes, accompanied by leukocytosis and re-elevation of serum G-CSF, developed just 3 months after the curative gastrectomy and adjuvant chemotherapy. All of the recurrent disease was resected, restoring normal levels of serum G-CSF. The patient survived for almost 2 years after the initial surgery with extensive chemotherapy, including weekly treatment with paclitaxel, before finally succumbing to liver failure secondary to extensive liver metastasis. |
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Keywords: | Granulocyte-colony stimulating factor Gastric cancer Chemotherapy Adenosquamous carcinoma |
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