title: Granulocyte colony-stimulating factor-producing hepatocellular carcinoma with abrupt changes.
abstract: Granulocyte colony-stimulating factor (G-CSF)-producing tumor is one of the rare types of cancer clinically characterized by an elevated fever and white blood cell (WBC) increment. Although G-CSF producing tumors have been reported in several types of cancer including those of the lungs, cervix and bladder, G-CSF producing hepatocellular carcinoma is extremely rare. Here, we report the case of a rapidly growing and poorly differentiated hepatocellular carcinoma producing G-CSF. The patient showed symptoms of continuous high fever, stomach pain and cough, and high serum WBC counts, C-reactive protein (CRP) and G-CSF levels were found in laboratory tests. After a radical hepatectomy, the patient completely recovered from the above symptoms and inflammatory state. The serum levels of G-CSF were reduced to normal levels after radical surgery. An immunohistochemical analysis revealed the overexpression of G-CSF in the cytoplasm of certain hepatocellular carcinoma (HCC) cell. The patient's serum WBC, CRP and G-CSF levels remained within normal levels in the six months after surgery without recurrence. This is the 9thcase report of G-CSF producing hepatocellular carcinoma in English literature. We review the clinical characteristics of the G-CSF producing HCC and discuss a possible treatment strategy.
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Hiroaki
authors: H
authors: Nagata
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Shuhei
authors: S
authors: Komatsu
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Wataru
authors: W
authors: Takaki
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Tokunari
authors: T
authors: Okayama
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Yasunori
authors: Y
authors: Sawabe
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Michiaki
authors: M
authors: Ishii
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Mitsuo
authors: M
authors: Kishimoto
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Eigo
authors: E
authors: Otsuji
authors: Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan.
authors: Hiroshi
authors: H
authors: Konosu
keywords: Granulocyte colony stimulating factor; Granulocyte colony-stimulating factor producing tumor; Hepatocellular carcinoma; Immunohistochemistry; Sarcomatous changes