A Case of Rapidly Enlarged G-CSF Producing Esophageal So-called Carcinosacoma Showing a Variety of Lesions

Koji Asai¹⁾²⁾, Seiji Igarashi¹⁾, Hideaki Shimizu²⁾, Hiroshi Miyata²⁾ and Jun Horiguchi³⁾

¹⁾Department of Pathology, Tochigi Cancer Center, ²⁾Department of Surgery, Tochigi Cancer Center, ³⁾Diagnostic Imaging, Tochigi Cancer Center

A 60-year-old man with dysphagia diagnosed via gastrointestinal endoscopy at a clinic as esophageal cancer and admitted to our hospital, had a white blood cell count of 12,400/mm³. Despite preoperative chemotherapy, leukocytes rose to 22,200/mm³ and blood granulocyte colony-stimulating factor (G-CSF) to 120 pg/ml. In only 1 month, the tumor quadrupled in size, chemotherapy was to be ended after 1 course, and subtotal esophagectomy conducted. Histopathologically, the lesion was so-called carcinosacoma at the tumor mass, adenocarcinoma at the pedicle, and basaloid carcinoma at the basilar portion. Postoperatively, the leukocyte count gradually decreased and G-CSF dropped to 25 pg/ml. Due to immunohistochemical studies showing positive staining for G-CSF in tumor cells, the man was diagnosed with a G-CSF-producing tumor. Although only 5 cases of G-CSF-producing esophageal carcinosacoma cases have been reported, none showed such a variable histological findings of our case, which appears to be very rare.

Key words
granulocyte-colony stimulating factor-producing tumor, carcinosarcoma of the esophagus, basaloid carcinoma

Reprint requests
Koji Asai Tochigi Cancer Center 4-9-13 Yohnan, Utsunomiya, 320-0834 JAPAN

Accepted
February 26, 2003

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