Granulocyte colony-stimulating factor-producing undifferentiated carcinoma of the colon mimicking a pulmonary giant cell carcinoma: a case showing overexpression of CD44 along with highly proliferating nestin-positive tumor vessels.
Granulocyte colony-stimulating factor (G-CSF)-producing tumors are known for their aggressive behavior. Only four cases of G-CSF-producing colorectal carcinoma have been previously reported. Herein, we present a case of an undifferentiated carcinoma of the descending colon showing G-CSF production and giant cell carcinoma morphology in a 93-year-old woman. A tumor with a diameter of 80 mm was identified in the descending colon via computed tomography. Descending colectomy was performed involving the abdominal wall where tumor invasion was observed. The white blood cell count, which was elevated before resection, decreased to normal levels after intervention. However, local recurrence at the resected site was detected 39 days after surgery. Upon recurrence, increased white blood cell counts and serum G-CSF were seen. The patient died because of respiratory failure 98 days after colectomy. By using immunohistochemistry, G-CSF expression was detected in tumor cells in the resected specimen, along with overexpression of CD44 and highly proliferating nestin-positive tumor vessels. The poor clinical outcome of this patient is consistent with previous reports that the expression of these three molecules predict poor prognosis. While G-CSF can be a therapeutic target considering its auto/paracrine function to induce tumor growth via the G-CSF receptor, CD44 and nestin may also be possible candidate therapeutic targets. Further studies are required to assess the efficacy of treatments targeting these three molecules.
Department of Pathology, Shizuoka Saiseikai General Hospital Shizuoka, Japan.
Shogo
S
Tajima
Department of Cell Biology and Anatomy, Hamamatsu University School of Medicine Shizuoka, Japan.
Michihiko
M
Waki
Department of Surgery, Shizuoka Saiseikai General Hospital Shizuoka, Japan.
Tomonori
T
Tsuchiya
Department of Pathology, Shizuoka Saiseikai General Hospital Shizuoka, Japan.
Shoji
S
Hoshi
D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D002277:Carcinoma / Q000098:blood supply* / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D018286:Carcinoma, Giant Cell / Q000175:diagnosis*; D003082:Colectomy; D003110:Colonic Neoplasms / Q000098:blood supply* / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000032:analysis*; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis*; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000175:diagnosis*; D009364:Neoplasm Recurrence, Local; D009389:Neovascularization, Pathologic; D064231:Nestin / Q000032:analysis*; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
D014408:Biomarkers, Tumor; C497483:CD44 protein, human; D018960:Hyaluronan Receptors; C577484:NES protein, human; D064231:Nestin; D016179:Granulocyte Colony-Stimulating Factor
CD44; Colon; giant cell carcinoma; granulocyte colony-stimulating factor; nestin; undifferentiated carcinoma