A Case of G-CSF-producing Metastatic Gastric Cancer from Lung Carcinoma

Masaki Ohi, Yuuki Morimoto, Tohru Ohsawa, Hiroshi Koike, Tetsuya Miyake and Yoshifumi Hirokawa*

Department of Surgery, Okanami General Hospital
The Second Department of Pathology, Mie University School of Medicine*

A 75-year-old man admitted for fever, general fatigue, and loss of appetite in June 2002 had been treated for lung carcinoma by right lobectomy in June 2001 and partial gastrectomy 8 month later elsewhere. Histopathological examination showed poorly differentiated squamous cell carcinoma in the lung and a metastatic lesion in the stomach. An upper gastrointestinal series and gastroscopy showed a protruded lesion in the gastric cardia. Suspecting malignant GIST or a metastatic tumor, we conducted proximal partial gastrectomy. Histopathologically the tumor had metastasized from lung carcinoma. Immunohistochemical staining with anti-G-CSF monoclonal antibody was positive in the lung stomach and preoperative serum G-CSF was abnormally high. The diagnosis was relatively rare G-CSF-producing metastatic gastric cancer. A mesenteric tumor of the transverse colon growing for a short time was resected in December 2002. Histopathological examination and Immunohistochemical staining with anti-G-CSF monoclonal antibody showed similar results. G-CSF-producing lung carcinoma with gastric metastasis has a dismal prognosis, and surgical treatment must be carefully selected considering the patient's quality of life.

Key words
metastatic gastric cancer, G-CSF-producing tumor, lung carcinoma

Reprint requests
Masaki Ohi Department of Surgery, Okanami General Hospital
1734 Uenokuwamachi, Iga, 518-0842 JAPAN

Accepted
January 26, 2005

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