Papillary thyroid carcinoma producing granulocyte-macrophage colony-stimulating factor is associated with neutrophilia and eosinophilia

Abstract

thyroid tumors producing colony-stimulating factors associated with neutrophilia and/or eosinophilia are very rare and almost all of them concern anaplastic thyroid cancer. Only one case of papillary thyroid carcinoma associated with neutrophilia and one case of medullary thyroid carcinoma associated with eosinophilia have been reported. In this report a 72-year old male patient with metastatic papillary thyroid carcinoma associated with neutrophilia and eosinophilia is described. While investigating the cause of neutrophilia and eosinophilia, a blind bone marrow biopsy of the posterior iliac crest was performed, which showed infiltration by papillary thyroid carcinoma. High blood levels of granulocyte-macrophage colony-stimulating factor (GM-csF) were found using an enzyme-linked immunosorbent assay. As other causes of neutrophilia and eosinophilia were excluded, we assumed that these were paraneoplastic manifestations induced by GM-csF produced by the thyroid tumor. the disease progressed rapidly, despite appropriate treatment which included thyroidectomy and postoperative radioactive 131 I administration. the patient died 11 months after diagnosis because of extensive lung metastasis. Neutrophilia and eosinophilia were stable findings, while serum thyroglobulin levels remained elevated throughout the follow-up period. to our knowledge, this is the first report of a patient with metastatic papillary thyroid carcinoma in whom with neutrophilia and eosinophilia associated with high circulating levels of GM-csF were detected.

Temporary changes in neutrophil-to-lymphocyte, platelet-to-lymphocyte ratios, and mean platelet volume reflecting the inflammatory process after radioiodine therapy

“…It has been speculated that neutrophilia could develop as a result of ectopic production of myeloid growth factors as part of a paraneoplastic syndrome or a nonspecific response to cancer-associated inflammation secondary to tissue destruction and cytokine releases [13,19]. Initially, higher NLR and PLR values versus the healthy controls may show the cancer-related inflammation in our RAI and non-RAI group.…”

Aggressive variants of follicular cell derived thyroid carcinoma; the so called ‘Real Thyroid Carcinomas’

“…Polymorphonuclear leukocytes can infiltrate the tumour and can be large in number near the necrotic regions83; some tumours have a prominent eosinophilic leukocytic infiltrate in areas that are not necrotic; tissue culture studies indicate that these types of anaplastic carcinomas can secrete an eosinophil chemotactic factor 90…”

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

“…Most G-CSFeproducing tumors are poorly differentiated and are likely to develop distant metastases. 8,11,12,[14][15][16][17][19][20][21][22] G-CSF stimulated the growth of a nonhematopoietic malignant cell line in vivo, 28 and G-CSF was also considered to be a major autocrine growth factor in rapid tumor proliferation and metastasis. 29 It has also been suggested that G-CSF has a priming effect on platelet aggregation and thrombin generation and subsequently induces a hypercoagulable state.…”

“…6 In addition, G-CSF can be used to mobilize hematopoietic stem cells from healthy donors to harvest stem cells for transplantation. 7 Several G-CSFeproducing malignant tumors have been reported in the lung, [8][9][10][11] urinary bladder, 12,13 digestive organs, [14][15][16][17][18][19] and thyroid gland, [20][21][22] but not in the breast. We present a rare case of a G-CSFeproducing spindle cell carcinoma of the left breast.…”