A Case of Granulocyte-Colony Stimulating Factor Producing Anaplastic Ductal Carcinoma of Pancreas

Nobuhisa Ando, Seisaku Fukuhara, Yutaka Mizuno and Hideyuki Ando

Department of Surgery, Tohnou Kosei Hospital

A 62-year-old woman hospitalized for fever and systemic malaise and referred for a pancreatic tumorous lesion detected by computed tomography (CT) and abdominal ultrasonography (US) was found in preoperative laboratory data to have leukocytosis (15,700 /mm³) and high serum CA19-9 (1,342 U/ml). CT showed an unevenly enhanced mass in the pancreatic tail that invaded to the spleen. US showed a heterogenous hypoechoic mass in the pancreatic tail. Following distal pancreatectomy, pathological examination showed anaplastic ductal carcinoma, and immunohistochemical study showed positive staining for G-CSF in the tumor cell, leading to a diagnosis of G-CSF-producing tumor. After the surgery, the leukocyte count continued to increase and the patient died on postoperative day 38 due to cancer cachexia and disseminated intravascular coagulation. G-CSF-producing pancreatic cancer is very rare, with 8 cases, including ours, having been reported.

Key words
granulocyte-colony stimulating factor, anaplastic ductal carcinoma of pancreas

Reprint requests
Nobuhisa Ando Department of Surgery, Tohnou Kosei Hospital
76-1 Toki-cho, Mizunami, 509-6101 JAPAN

Accepted
October 19, 2004

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