title: Cholangiocellular carcinoma that produced both granulocyte-colony-stimulating factor and parathyroid hormone-related protein.
abstract: A 56-year-old man was admitted to our hospital because of consciousness disturbance. Abdominal computed tomography revealed a large low-density tumor in the left lobe of the liver. He presented with marked leukocytosis and hypercalcemia with high levels of serum granulocyte-colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTH-rP). A diagnosis of cholangiocellular carcinoma (CCC) of the liver was confirmed by histological examination of an autopsy specimen. The tumor cells showed positivity for both G-CSF and PTH-rP with immunohistochemical staining. These results suggest that the tumor was producing both G-CSF and PTH-rP. This paraneoplastic G-CSF and PTH-rP production caused by CCC is very rare. Such cases must be followed up carefully, since tumors associated with paraneoplastic syndrome progress rapidly, resulting in a poor prognosis.
authors.affiliation: Third Department of Medicine, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. tetsuro@fukuoka-u.ac.jp
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sohda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shiga
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nakane
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Morishige
authors.initials: M
authors.lastname: Takeshita
authors.forename: Shotaro
authors.initials: S
authors.lastname: Sakisaka
mesh_terms: D001650:Bile Duct Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D007150:Immunohistochemistry; D007964:Leukocytosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes; D044162:Parathyroid Hormone-Related Protein / Q000378:metabolism*
chemical_list: D044162:Parathyroid Hormone-Related Protein; D016179:Granulocyte Colony-Stimulating Factor