A case of granulocyte-colony stimulating factor producing gastric cancer in a young adult

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 73; no. 7; pp. 1686 - 1690
• Main Authors: ENJOJI, Megumu, INOKUCHI, Mikito, KAWANO, Tatsuyuki, MURASE, Hideaki, KOJIMA, Kazuyuki, SUGIHARA, Kenichi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2012
• Subjects: gastric cancer; G–CSF–producing neoplasm
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.73.1686

A 29-year-old man presented with dysphagia. Upper gastrointestinal endoscopy revealed a type-2 gastric cancer ; based on the pathology of a biopsy specimen, a moderately differentiated adenocarcinoma was diagnosed. Laboratory tests indicated leukocytosis (38,800/μl), but no evidence of infection was observed. The serum granulocyte-colony stimulating factor (G-CSF) level was elevated, thus a G-CSF-producing gastric cancer was suspected. A total gastrectomy was performed. On pathology, the tumor was T4a(SE), N2, H0, P0, CY0, M0, Stage III B, and G-CSF immunohistochemical staining was positive. After the operation, both the leukocyte count and the serum G-CSF level decreased. Metastases in the liver and lymph nodes were detected 3 months after surgery. Chemotherapy (1st : TS-1/docetaxel, 2nd : CDDP/CPT- 11) proved ineffective, and the patient died 7 months after surgery ; his highest leukocyte count level was 148,800/μl.