Hypopharyngeal squamous cell carcinoma producing both granulocyte colony-stimulating factor and parathyroid hormone-related protein.
A 57-year-old woman was admitted to Hokkaido University Hospital because of dysphagia. Laryngoscopy indicated hypopharyngeal tumor histologically diagnosed as squamous cell carcinoma (SCC). A combination of radiotherapy and chemotherapy was performed for 2 months, and the hypopharyngeal lesion completely regressed. After 4 months, fever, anorexia, and malaise appeared, and chest X-ray and CT indicated two large tumors in the right lung. Transbroncheal lung biopsy (TBLB) specimens were diagnosed as SCC. Laboratory data showed high levels of serum granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP). Subsequently, positron emission tomography (PET) showed multiple metastases to several organs including the liver, spine, skull, and thigh. Two months after readmission, the patient died with no success of chemotherapy. At autopsy, the lung tumor was clearly positive for both G-CSF and PTHrP on immunohistostaining. Retrospectively, examination showed that the primary pharyngeal tumor was focally positive for these two cytokines. Thus, a certain population of hypopharyngeal cancer producing G-CSF and PTHrP, spread to various organs and contributed to the rapid progression and poor prognosis. This case is presented with a discussion of several other cases in the literature.
Tamura
Kanae
K
Laboratory of Molecular and Cellular Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. tanaka@med.hokudai.ac.jp
Yoshinaga
Tomoaki
T
Tanino
Mishie
M
Kimura
Taichi
T
Yamada
Noriyuki
N
Nishimura
Masaharu
M
Fukuda
Satoshi
S
Nishihara
Hiroshi
H
Shindoh
Masanobu
M
Tanaka
Shinya
S
D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D008175:Lung Neoplasms / Q000378:metabolism / Q000556:secondary; D008875:Middle Aged; D044162:Parathyroid Hormone-Related Protein / Q000097:blood*
D044162:Parathyroid Hormone-Related Protein; D016179:Granulocyte Colony-Stimulating Factor