title: A case of anaplastic carcinoma of the pancreas producing granulocyte-colony stimulating factor.
abstract: We report a case of anaplastic carcinoma of the pancreas with production of granulocyte-colony stimulating factor (G-CSF) in a 59-year-old male. He was referred to our hospital with a chief complaint of epigastralgia and suffered from leukocytosis. Differential diagnosis included pancreatic tumors and submucosal tumor of the stomach, but definite preoperative diagnosis could not be made. He underwent distal pancreactomy, total gastrectomy with Roux-en-Y reconstruction and splenectomy. He recovered uneventfully postoperatively and was discharged from hospital on the 14th postoperative day. Histological examination showed anaplastic carcinoma of the pancreas. Since the peripheral leukocyte count was sharply decreased after the operation, we suspected the tumor would be producing G-CSF. Then immunohistochemistry showed a positive stain in the tumor. Therefore, we diagnosed the tumor as anaplastic carcinoma of the pancreas producing G-CSF. Three months after the resection, local recurrence was detected by abdominal computed tomography. The patient died of hemorrhagic shock due to tumor invasion of the intestine 8 months after the operation.
authors.affiliation: Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8527, Japan. t147028@siz.saiseikai.or.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Murata
authors.affiliation: Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8527, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Terasaki
authors.affiliation: Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8527, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakaguchi
authors.affiliation: Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8527, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Okubo
authors.affiliation: Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8527, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukami
authors.affiliation: Department of Surgery, Shizuoka Saiseikai General Hospital, 1-1-1 Oshika, Suruga-ku, Shizuoka, 422-8527, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Nishimae
authors.affiliation: Department of Pathology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitayama
authors.affiliation: Department of Pathology, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Hoshi
keywords: Anaplastic carcinoma; Granulocyte-colony stimulating factor; Pancreas