title: Gastric adenosquamous carcinoma producing granulocyte-colony stimulating factor.
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.
authors.affiliation: Department of General Surgery, Fukuoka Dental College Hospital, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Endo
authors.forename: Shunji
authors.initials: S
authors.lastname: Kohnoe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamura
authors.forename: Masaru
authors.initials: M
authors.lastname: Haraguchi
authors.forename: Eisuke
authors.initials: E
authors.lastname: Adachi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toh
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D018196:Carcinoma, Adenosquamous / Q000150:complications / Q000378:metabolism* / Q000628:therapy; D017809:Fatal Outcome; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006801:Humans; D007964:Leukocytosis / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications / Q000378:metabolism* / Q000628:therapy
chemical_list: D016179:Granulocyte Colony-Stimulating Factor