title: A case of anaplastic ductal carcinoma of the pancreas with production of granulocyte-colony stimulating factor.
abstract: We report a case of anaplastic ductal carcinoma of the pancreas with production of granulocytecolony stimulating factor in a 46-year-old man. He underwent distal pancreatectomy, total gastrectomy with Roux-en-Y reconstruction and splenectomy. He recovered uneventfully postoperatively and was discharged from hospital on the 22nd postoperative day. Histological examination showed anaplastic ductal carcinoma (giant cell type) of the pancreas. However, three months after the operation, multiple liver metastases were demonstrated by CT scan and the peripheral leukocyte count rose to 81,800/microL. Serum granulocyte-colony stimulating factor concentration was 155pg/mL (normal 5.78-27.5 pg/mL). Therefore, we diagnosed granulocyte-colony stimulating factor-producing pancreatic cancer. Anaplastic ductal carcinoma of the pancreas with production of granulocyte-colony stimulating factor is very rare. Tumors with production of granulocyte-colony stimulating factor are highly malignant, and this patient died of hepatic failure four months after the operation.
authors.affiliation: Department of Hepatobiliary-Pancreatic Surgery, National Cancer Center Hospital East, Chiba, Japan. ngotohda@east.ncc.go.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Norio
authors.initials: N
authors.lastname: Saito
authors.forename: Masato
authors.initials: M
authors.lastname: Ono
authors.forename: Masanori
authors.initials: M
authors.lastname: Sugito
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.forename: Kazuto
authors.initials: K
authors.lastname: Inoue
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Oda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D044584:Carcinoma, Ductal / Q000378:metabolism* / Q000556:secondary / Q000601:surgery*; D017809:Fatal Outcome; D005743:Gastrectomy; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006801:Humans; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D011859:Radiography; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000556:secondary / Q000601:surgery; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D016179:Granulocyte Colony-Stimulating Factor