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Granulocyte-colony-stimulating factor-producing metaplastic carcinoma of the breast with significant elevation of serum interleukin-17 and vascular endothelial growth factor levels

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Abstract

Granulocyte-colony-stimulating factor (G-CSF) production in carcinomas is associated with a very aggressive phenotype. Interleukin (IL)-17 secreted from tumor-infiltrating lymphocytes induces the production of G-CSF and vascular endothelial growth factor (VEGF) in cancer tissue. We present a case of a G-CSF-producing metaplastic breast carcinoma (MpBC) accompanied by systemic elevation of IL-17 and VEGF levels. A 56-year-old woman presented with a rapidly growing tumor measuring > 10 cm in her left breast. Core needle biopsy confirmed the diagnosis as MpBC with triple-negative features. Diffuse fluorodeoxyglucose uptake in the long bones and marked leukocytosis suggested that the G-CSF was produced by the primary tumor, which showed upregulated G-CSF mRNA and protein levels. Multiplex cytokine assessment identified increased serum IL-17, VEGF, and G-CSF levels. After radical mastectomy and skin grafting, the leukocyte count and serum G-CSF, IL-17, and VEGF levels were normalized. She underwent postmastectomy radiotherapy (50 Gy/25 Fr) and adjuvant chemotherapy (90 mg/m2 of epirubicin and 600 mg/m2 of cyclophosphamide followed by 80 mg/m2 of paclitaxel) and is alive without recurrence. This is the first in vivo observation that describes the systemic elevation of IL-17 and VEGF levels with concomitant G-CSF production. Further research is warranted to study the IL-17/G-CSF/VEGF axis as a potential therapeutic target for this aggressive type of breast cancer.

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Acknowledgements

We thank all the patients and medical staff of the Kyoto University Hospital for their support.

Author information

Authors and Affiliations

  1. Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Yukiko Fukui, Masahiro Kawashima, Kosuke Kawaguchi, Megumi Takeuchi & Masakazu Toi

  2. Department of Diagnostic Pathology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Masahiro Hirata, Tatsuki R. Kataoka & Takaki Sakurai

  3. Department of Diagnostic Radiology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Masako Kataoka, Shotaro Kanao & Yuji Nakamoto

  4. Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Kimiko Hirata & Michio Yoshimura

  5. Department of Plastic Surgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, 524-8524, Japan

    Katsuhiro Yoshikawa

  6. Department of Medical Oncology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763, Japan

    Hiroshi Ishiguro

Authors
  1. Yukiko Fukui
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  2. Masahiro Kawashima
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  3. Kosuke Kawaguchi
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  4. Megumi Takeuchi
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  5. Masahiro Hirata
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  6. Tatsuki R. Kataoka
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  7. Takaki Sakurai
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  8. Masako Kataoka
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  9. Shotaro Kanao
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  10. Yuji Nakamoto
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  11. Kimiko Hirata
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  12. Michio Yoshimura
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  13. Katsuhiro Yoshikawa
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  14. Hiroshi Ishiguro
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  15. Masakazu Toi
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Corresponding author

Correspondence to Yukiko Fukui.

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Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

The tests presented in this report were performed under the approval of the Ethics Committee of Kyoto University Hospital (Protocol number; G424).

Informed consent

Written informed consent for the usage of patient-derived resources was obtained from the patients prior to the research and the publication.

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Fukui, Y., Kawashima, M., Kawaguchi, K. et al. Granulocyte-colony-stimulating factor-producing metaplastic carcinoma of the breast with significant elevation of serum interleukin-17 and vascular endothelial growth factor levels. Int Canc Conf J 7, 107–113 (2018). https://doi.org/10.1007/s13691-018-0330-5

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  • DOI: https://doi.org/10.1007/s13691-018-0330-5

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