A case of anaplastic carcinoma of the pancreas producing granulocyte-colony stimulating factor

Abstract

We report a case of anaplastic carcinoma of the pancreas with production of granulocyte-colony stimulating factor (G-CSF) in a 59-year-old male. He was referred to our hospital with a chief complaint of epigastralgia and suffered from leukocytosis. Differential diagnosis included pancreatic tumors and submucosal tumor of the stomach, but definite preoperative diagnosis could not be made. He underwent distal pancreactomy, total gastrectomy with Roux-en-Y reconstruction and splenectomy. He recovered uneventfully postoperatively and was discharged from hospital on the 14th postoperative day. Histological examination showed anaplastic carcinoma of the pancreas. Since the peripheral leukocyte count was sharply decreased after the operation, we suspected the tumor would be producing G-CSF. Then immunohistochemistry showed a positive stain in the tumor. Therefore, we diagnosed the tumor as anaplastic carcinoma of the pancreas producing G-CSF. Three months after the resection, local recurrence was detected by abdominal computed tomography. The patient died of hemorrhagic shock due to tumor invasion of the intestine 8 months after the operation.

Granulocyte-colony stimulating factor producing mucinous cystic neoplasm with an associated invasive carcinoma of the pancreas

“…These findings indicate that the progression from non-invasive MCN to invasive carcinoma occurs over a period of years. The histology of G-CSF-producing neoplasms of the pancreas, including unconventional tumors such as adenosquamous carcinoma or anaplastic carcinoma, has been previously described (6,7,9,10,14,15). However, to the best of our knowledge, there are no reports concerning MCNs, and this is the first study to identify positive G-CSF immunostaining in a patient with MCN with an associated invasive carcinoma.…”

“…Histologically, anaplastic carcinoma (7,10,14,15), poorly differentiated adenocarcinoma (8), and adenosquamous carcinoma (6,9) are the dominant subtypes of G-CSF-producing pancreatic tumor. To the best of our knowledge, an incidence of MCN with associated invasive carcinoma of the pancreas has not been reported in the English or Japanese literature.…”

Cytopathology of anaplastic carcinoma of the pancreas: Review of a rare entity and description of a variant with signet ring cell features

“…7 Severe anemia (hemoglobin level < 10.0 g/dL) and elevated leucocyte count (>12 000/mm 3 ) have been observed in patients with ACP, and were attributed to rapid tumor growth, followed by hemorrhage and necrosis. 10 In addition, granulocyte-colony stimulating factor is detected in some patients with ACP, contributing to leucocytosis, [10][11][12][13] and conferring a poorer prognosis. 10,11 Inconsistencies of reported blood levels of CA19-9 and CEA exist in different studies.…”

Pseudomesotheliomatous carcinoma of the pleura: an autopsy case of metastasis from a G‐CSF‐producing anaplastic carcinoma of the pancreas

“…The most common origins of G-CSF-producing tumors include the lungs, urinary tract, and stomach (4). G-CSF-producing pancreatic cancer is rare, and only eight cases of anaplastic carcinoma were previously reported (3,(5)(6)(7)(8)(9)(10)(11). To our knowledge, this is the first case of showing pseudomesotheliomatous carcinoma due to pleural metastasis from a G-CSF-producing anaplastic carcinoma of the pancreas.…”