A Case of Granulocyte-Colony Stimulating Factor–Producing Spindle Cell Carcinoma of the Breast

Suzuki, Keisuke; Ota, Daisuke; Nishi, Tsunehiro; Mori, Masaya; Kato, Takao; Takeuchi, Masashi; Tsuji, Munechika; Teraoka, Megumi; Fukuuchi, Atsushi

doi:10.1016/j.clbc.2015.02.003

Cited by 7 publications

(10 citation statements)

References 30 publications

(38 reference statements)

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“…We treated a patient with G-CSF-producing malignant phyllodes tumor of the breast. It was a triple-negative type malignant tumor that was mainly composed of atypical stromal cells as in the past two reported cases [ 5 , 11 ]. Including this case, a G-CSF-producing tumor has presented as a malignant tumor mainly composed of stromal cells.…”

Section: Discussionmentioning

confidence: 99%

Granulocyte-colony stimulating factor-producing malignant phyllodes tumor of the breast: a rare case

et al. 2021

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Background Granulocyte-colony stimulating factor (G-CSF)-producing tumors can cause leukocytosis despite an absence of infection. G-CSF-producing tumors have been reported in various organs such as the lung, esophagus, and stomach but rarely in the breast. We report a case of G-CSF-producing malignant phyllodes tumor of the breast. Case presentation An 84-year-old woman visited our hospital complaining of a lump in her left breast without fever and pain. Laboratory tests revealed elevated white blood cell (WBC) count and G-CSF levels. A malignant tumor of the breast was diagnosed by core needle biopsy. We performed a total mastectomy and sentinel lymph node biopsy. The tumor was identified as a G-CSF-producing malignant phyllodes tumor. Within 7 days after surgery, the patient’s WBC count and G-CSF level had decreased to normal levels. She is alive without recurrence 13 months after surgery. Conclusions We encountered a rare case of G-CSF-producing malignant phyllodes tumor of the breast. PET–CT revealed diffuse accumulation of FDG in the bone. Phyllodes tumors need to be differentiated from bone metastasis, lymphoma, and leukemia. We must be careful to not mistake this type of tumor for bone marrow metastasis.

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Section: Discussionmentioning

confidence: 99%

Granulocyte-colony stimulating factor-producing malignant phyllodes tumor of the breast: a rare case

et al. 2021

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“…Although it was a paraneoplastic epiphenomenon, the presence of G‐CSF produced by tumor cells is far from incidental on a tumor development. The cancer‐related G‐CSF could stimulate the BM and EMH to produce super large number of MDSCs resulting in severe leukemoid reaction leading to a very poor prognosis . A study reported that invasive breast cancer reprograms early myeloid differentiation to generate immunosuppressive neutrophils .…”

Section: Discussionmentioning

confidence: 99%

“…Granulocyte colony‐stimulating factor (G‐CSF) is a cytokine produced by macrophages, fibroblasts, and endothelial cells. A cancer‐associated leukemoid reaction with extramedullary hematopoiesis (EMH) and splenomegaly could be induced by G‐CSF which was released by a variety of tumors, including breast cancers in animals and humans . G‐CSF appears to promote cancer progression either directly by STAT3 signal or indirectly by stimulating myeloid‐derived suppressor cells (MDSCs) proliferation .…”

Section: Introductionmentioning

confidence: 99%

EphA4‐deleted microenvironment regulates cancer development and leukemoid reaction of the isografted 4T1 murine breast cancer via reduction of an IGF1 signal

et al. 2016

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EphA4 belongs to the largest family of receptor tyrosine kinases (RTKs). Although EphA4 is highly expressed in the central nervous system, EphA4 has also been implicated in cancer progression. Most of the studies focus on the expression and function in tumor cells. It is unknown whether EphA4‐deleted microenvironment affects tumor progression. Some of cancers in animals and humans, such as 4T1 cancer cells, are known to produce a large amount of granulocyte colony‐stimulating factors (G‐CSF/Csf3) which can stimulate myeloproliferation, such as myeloid‐derived suppressor cells (MDSCs) leading to a poor recipient prognosis. We isografted 4T1 breast cancer cells into both EphA4‐knockout and control wild‐type female littermate mice. The results showed that the EphA4‐deleted host could inhibit primary tumor growth and tumor metastasis mainly by decreasing the amount of IGF1 synthesis in the circulation and locally tissues. The EphA4‐deleted microenvironment and delayed tumor development reduced the production of G‐CSF resulting in the decrease of splenomegaly and leukemoid reaction including MDSCs, which in turn inhibit the tumor progression. This inhibition can be reversed by supplying the mice with IGF1. However, an excess of IGF1 supply over demand to the control mice could not further accelerate the tumor growth and metastasis. A better understanding and re‐evaluation of the main role of IGF1 in regulating tumor progression could further enhance our cognition of the tumor development niche. Our findings demonstrated that EphA4‐deleted microenvironment impairs tumor‐supporting conditions. Conclusion: Host EphA4 expression regulates cancer development mainly via EphA4‐mediated IGF1 synthesis signal. Thus, targeting this signaling pathway may provide a potential therapeutic option for cancer treatment.

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“…The patient is currently alive without relapse at 30 months postoperative. breast cancer, including our case [1][2][3][4][5][6][7][8][9][10][11][12] (Table 1). Such tumors have a large proportion of special tissue type, and squamous cell carcinoma is a frequent type.…”

Section: Postoperative Coursementioning

confidence: 99%

A Case of a Rapidly Growing Granulocyte Colony-Stimulating Factor-Producing Squamous Cell Carcinoma of the Breast

et al. 2021

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A 34-year-old woman with a rapidly growing right breast mass visited our hospital. The mass was diagnosed as a right breast cancer (cT3N1M0 stage ⦀A). Her serum leucocyte count and C-reactive protein levels were high, and she had persistent fever. However, serum procalcitonin and β-D-glucan levels were normal, and no apparent infection focus was detected, although her serum granulocyte colony-stimulating factor (G-CSF) level was markedly elevated to 42.7 pg/mL. Therefore, a G-CSF-producing breast cancer was suspected. A pathological analysis of the surgical specimen revealed a squamous cell carcinoma of the breast (pT2N0 [i+] M0 stage ∥A). Right mastectomy (with the resection of the pectoralis major muscle), axillary lymph node dissection, and split layer grafting were performed. The leucocyte count and serum G-CSF level decreased on postoperative day (POD) 1 and normalized on POD 6. As adjuvant chemotherapy, 4 cycles of a combination chemotherapy with adriamycin and cyclophosphamide and 12 cycles of weekly paclitaxel were administered. After chemotherapy, the patient also underwent postmastectomy radiotherapy. Currently, 30 months after surgery, the patient is alive and well with neither progression nor distant metastasis. G-CSF-producing breast cancers tend to rapidly grow such as in the current case; thus, surgery should be performed immediately, followed by appropriate adjuvant treatment.

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A Case of Granulocyte-Colony Stimulating Factor–Producing Spindle Cell Carcinoma of the Breast

Cited by 7 publications

References 30 publications

Granulocyte-colony stimulating factor-producing malignant phyllodes tumor of the breast: a rare case

Granulocyte-colony stimulating factor-producing malignant phyllodes tumor of the breast: a rare case

EphA4‐deleted microenvironment regulates cancer development and leukemoid reaction of the isografted 4T1 murine breast cancer via reduction of an IGF1 signal

A Case of a Rapidly Growing Granulocyte Colony-Stimulating Factor-Producing Squamous Cell Carcinoma of the Breast

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