肺転移巣からG-CSF産生を認めた下顎歯肉扁平上皮癌の1例  [in Japanese] A case of lower gingival squamous cell carcinoma with granulocyte colony-stimulating factor (G-CSF) producing pulmonary metastatic tumors  [in Japanese]

今回われわれはG-CSF産生腫瘍と診断した下顎歯肉扁平上皮癌の1例を経験したので報告する。患者は87歳の女性。約6か月前より右側下顎歯肉の腫瘤形成を認めるも放置していた。その後，腫瘤が徐々に増大してきたため精査を希望し当科を受診した。右側下顎歯肉扁平上皮癌の診断下，手術を施行した。術後2か月目に胸部X線写真とPET-CTにて肺転移を認め，同時に急激な白血球増加症を認めた。術後3か月目に肺転移腫瘍による呼吸不全にて死亡した。術後，肺転移巣の組織検査の結果，肺転移巣は免疫組織学的にG-CSF陽性であった。これらの所見から，歯肉癌の肺転移巣がG-CSFを産生し，白血球増殖症をひきおこしたことが示唆された。

We report a case of lower gingival squamous cell carcinoma producing granulocyte colony-stimulating factor (G-CSF) of an 87-year-old woman. She was referred to our department with the chief complaint of a granulated mass in the right lower gingiva, which had persisted for 6 months. Pathological examination of a biopsy specimen revealed a moderately differentiated squamous cell carcinoma. Tumor resection was performed under general anesthesia. Two months post-operatively, lung metastasis of the tumor was observed, and laboratory findings showed marked leukocytosis. Lung metastasis tumor was diagnosed pathologically as a moderately differentiated squamous cell carcinoma. Immunohistochemical staining with monoclonal anti-G-CSF antibody was positive, so we diagnosed squamous cell carcinoma producing granulocyte colony-stimulating factor. Unfortunately, the patient expired 3 months post-operatively.