A Case of Granulocyte-Colony Stimulating Factor-Producing Gastric Cancer

Yasunori Akutsu, Masato Endo, Toshihiko Hoshino, Mari Kuboshima, Akiko Kagaya, Yozo Tsunoda and Takenori Ochiai^*

Department of Surgery, Kumagaya General Hospital
Department of Academic Surgery, Graduate School of Medicine, Chiba University^*

We report a case of G-CSF-producing gastric cancer with multiple liver metastases. A 55-year-old male who complained of general fatigue and of tarry stools was admitted to our hospital. Endoscopy and X-ray examination revealed a type-3 gastric cancer. The pre-operative laboratory data indicated leukocytosis (18,610/mm³) and a high level of G-CSF (76 pg/ml). Since we detected multiple liver metastases, so chemotherapy was performed. Because of bleeding from the gastric cancer, however, the patient underwent a total gastrectomy on November 11, 2002. The surgical stage was T3N3P0H3, stage IV. The pathological diagnosis was; tub2, se, pm-, dm-, ly3, v3, n3, stage IV. After the operation, the hepatic metastasis progressed and the serum G-CSF level increased up to 250 pg/ml. The patient died of hepatic failure on February 5, 2003. G-CSF-producing gastric cancer is rare and we summarize previous reports.

Key words
granulocyte-colony stimulating factor, gastric cancer, leukocytosis

Reprint requests
Yasunori Akutsu Department of Surgery, Kumagaya General Hospital 4-5-1 Nakanishi, Kumagaya, 360-8567 JAPAN

Accepted
May 27, 2003

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