G-CSF産生直腸未分化癌の1例 [in Japanese] A CASE OF GRANULOCYTE-COLONY STIMULATING FACTOR (G-CSF)-PRODUCING UNDIFFERENTIATED CARCINOMA ARISING IN THE RECTUM [in Japanese]
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This paper deals with a case of granulocyte-colony stimulating facor (G-CSF)-producing undifferentiated carcinoma of the rectum in which the disease rapidly progressed to its termination after resection of the primary lesion. A 63-year-old man was admitted to our hospital for thorough examination of a large tumor of the rectum, for which undifferentiated carcinoma was suggested. Because of bleeding from the tumor and no evident metastasizing lesions demonstrated by PET-CT, we performed abdominoperineal rectum resection. However, it became apparent by the 11<SUP>th</SUP> postoperative day that the disease had relapsed in the pelvic cavity with multiple metastasizing lesions in the liver and lungs. Also noted were a high-grade fever with marked leukocytosis (>110000/μl) and an elevated serum G-CSF level (115pg/ml) during this period. Afterwards, the patient's condition rapidly deteriorated and he died 26 days after the surgery. Microscopic examination including immunohistochemical staining gave a diagnosis of undifferentiated carcinoma. Furthermore, tumor cells positively stained for anti-G-CSF antibody.<BR>Reports of undifferentiated carcinoma arising in the large bowel are extremely rare and, to the best of our knowledge, no G-CSF-producing undifferentiated carcinoma of the rectum has not been documented to date. Thus, the significance of G-CSF in the clinical course and therapeutic strategies for such patients remain unresolved. Nevertheless, a review of the literature suggests that early detection followed by complete resection of such tumors would be the best possible therapeutic modality at this point.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 69(7), 1737-1741, 2008-07-25
Japan Surgical Association