Hepatocellular carcinoma producing granulocyte colony-stimulating factor: diagnosis and treatment
- 17 Downloads
Granulocyte colony-stimulating factor (G-CSF) is a naturally occurring glycoprotein that is synthesized by stromal cells in bone marrow. Several cases of G-CSF-producing malignant tumors in various organs have been reported, but it is extremely rare in hepatocellular carcinoma (HCC). Here, we report a rare case of HCC producing G-CSF. The patient presented with a continuous fever and had a huge liver mass in the right lobe with portal vein tumor thrombus (PVTT) in the right first branch. He had marked granulocytosis, and his serum level of G-CSF was elevated. A complete curative liver resection was performed after preoperative radiotherapy to PVTT. The pathological findings of the resected specimen revealed poorly/moderately differentiated HCC, and immunohistochemical staining of G-CSF was negative the first time it was tested, but the second time, it was positive in the cytoplasm of other tumor cells of HCC. Only a few cases of G-CSF-producing HCC have been reported, and they resulted in rapid tumor growth, metastases, and poor prognosis. In our case with PVTT, there was no liver recurrence, although multiple lung metastases occurred at 8 months after curative resection. We should consider G-CSF-producing HCC and diagnose promptly when encountering liver tumor patients with leukocytosis, and we should perform multimodal treatment including radiation, radical surgery, and chemotherapy.
KeywordsG-CSF-producing tumor Hepatocellular carcinoma Radical surgery Immunohistochemistry Chemotherapy
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study is approved by the ethics committee of Hokkaido University Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from the patient.
- 2.Asano S, Urabe A, Okabe T et al (1977) Demonstration of granulopoietic factor(s) in the plasma of nude mice transplanted with a human lung cancer and in the tumor tissue. Blood 49:845–852Google Scholar
- 4.Ito N, Matsuda T, Kakehi Y et al (1990) Bladder cancer producing granulocyte colony-stimulating factor. N Engl J Med 323:1709–1710Google Scholar
- 12.Berdel WE, Danhauser-Riedl S, Steinhauser G et al (1989) Various human hematopoietic growth factors (interleukin-3, GM-CSF, G-CSF) stimulate clonal growth of nonhematopoietic tumor cells. Blood 73:80–83Google Scholar
- 14.Ito T, Okubo K, Shiomi M et al (2012) [A case of successful treatment of granulocyte colony-stimulating factor producing hepatocellular carcinoma accompanying type B hepatitis with tegafur–uracil.]. Nihon Shokakibyo Gakkai Zasshi 109:2088–2096Google Scholar
- 18.Snyder RA, Liu E, Merchant NB (2012) Granulocyte colony stimulating factor secreting hepatocellular carcinoma. Am Surg 78:821–822Google Scholar