title: Granulocyte colony-stimulating factor-producing cholangiocellular carcinoma.
abstract: A 61-year-old female was admitted to our hospital with epigastric pain and fever. The laboratory data showed severe inflammatory reactions. Computed tomography revealed an irregular tumor in the left hepatic lobe and swelling of lymph nodes. (18)F-fluorodeoxy-glucose positron emission tomography (FDG-PET) showed high uptake by the tumor, with diffuse uptake in the spine. Based on the elevated leukocyte count and FDG-PET findings, the patient was diagnosed with a granulocyte colony-stimulating factor (G-CSF)-producing tumor (G-CSF, 213 pg/mL). We performed left trisegmentectomy of the liver, bile duct resection, and lymph node dissection. Histologically, the tumor was a poorly differentiated adenocarcinoma with some lymph nodes metastasis. Immunohistochemical staining of the tumor cells was positive for G-CSF. Therefore, the tumor was diagnosed as G-CSF-producing cholangiocellular carcinoma. The inflammatory reactions and serum G-CSF level transiently improved immediately after surgery. However, 1 month later, the leukocyte count and serum G-CSF level increased again, and recurrence was observed in the remnant liver. The patient died 3 months after the operation. G-CSF-producing cholangiocellular carcinoma is rare. This tumor progresses rapidly, and surgical treatment for advanced condition should be carefully selected.
authors.affiliation: 1 Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzumura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iimuro
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Hirano
authors.forename: Yasukane
authors.initials: Y
authors.lastname: Asano
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Kuroda
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Okada
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Keiji
authors.initials: K
authors.lastname: Nakasho
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000378:metabolism*; D006498:Hepatectomy; D006801:Humans; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor; D016179:Granulocyte Colony-Stimulating Factor
keywords: Cholangiocellular carcinoma; FDG-PET; Granulocyte colony-stimulating factor; Immunohistochemistry; Leukocytosis