A Case of Surgery for a Granulocyte-Colony Stimulating Factor-Producing Esophageal Carcinosarcoma which resulted in a Long-Term Survival

Hiroaki Ito, Akio Harada, Tomoyoshi Deguchi, Shigeru Konishi, Satoshi Sueoka, Fuminori Sonohara, Yayoi Yoshida, Noriyuki Miyajima and Mitsuru Tashiro

Department of Surgery, Gifu Prefectural Tajimi Hospital

A 70-year-old man seen for a tight sensation during swallowing was found to have a Type-1 tumor of the lower thoracic esophagus and hospitalized for a continuous fever of 38°C or higher. His white blood cell count (WBC) was 18,100 /mm³ and CRP 22.64 mg/dl. His fever persisted as did his high WBC of 20,500 /mm³ and CRP of 25.09 mg/dl. Serum G-CSF high at 64 pg/ml (normal: 18 pg/ml or lower), he was diagnosed with a G-CSF-producing tumor, necessitating resection of the middle and lower esophagus, dissection of 2 regions, resection of the subtotal gastric tube, and intrathoracic anastomosis. Pathological evaluation indicated epithelial and non epithelial tumor components, indicating esophageal carcinosarcoma. GCSF immunostaining was positive for syncytium in tumor cells. Progression based on TNM classification was pT2, pN0, M0, and pStage IIA. The postoperative course was good, his condition returned to normal, and he was discharged on postoperative day 38. No recurrence has been seen in the five years since surgery.

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

Reprint requests
Hiroaki Ito Department of Surgery, Gifu Prefectural Tajimi Hospital
5-161 Maehatacho, Tajimi, 507-8522 JAPAN

Accepted
January 27, 2010

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