A 60-year-old female was admitted to hospital with a continuous fever, a decreased appetite, and abdominal pain. Laboratory tests showed an elevated peripheral leukocyte count (13,800/μl) and increased C-reactive protein (19.1 mg/dl) and carbohydrate antigen 19–9 (4057 U/ml) levels. Abdominal contrast-enhanced computed tomography showed multiple bulky hypovascular nodules in the liver, swelling of the paraaortic lymph nodes, and a hypovascular mass (diameter 3.0 cm) in the pancreatic body. The serum concentrations of granulocyte colony-stimulating factor (G-CSF) and interleukin-6 were 172 pg/μl and 541 pg/µl, respectively. Liver biopsy specimens revealed an adenosquamous carcinoma, which was positively immunostained for G-CSF. We diagnosed the patient with G-CSF-producing pancreatic cancer with multiple metastases. Four courses of gemcitabine with dexamethasone and one course of nab-paclitaxel and gemcitabine were administered. Although the pancreatic tumor and paraaortic lymph node metastases decreased in size, the liver metastases continued to grow. The patient died 4 months after the diagnosis of pancreatic cancer. An autopsy resulted in the tumor being diagnosed as poorly differentiated adenosquamous pancreatic carcinoma, which was histopathologically G-CSF-positive. Although G-CSF-producing pancreatic adenosquamous carcinomas are extremely rare, they have been encountered more frequently in recent years. In such cases, chemotherapy combined with dexamethasone might be effective at temporarily improving the patient’s condition.
This is a preview of subscription content, log in to check access.
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Asano S, Urabe A, Okabe T, et al. Demonstration of granulopoietic factor(s) in the plasma of nude mice transplanted with a human lung cancer and in the tumor tissue. Blood. 1977;49:845–52.CrossRefGoogle Scholar
Ohwada S, Miyamoto Y, Fujii T, et al. Colony stimulating factor producing carcinoma of the pancreas-a case report. Gan No Rinsho. 1989;35:523–7.PubMedGoogle Scholar
Takami K, Miura K, Takeuchi H, et al. Granulocyte-colony stimulating factor-producing pancreatic cancer: report of a case. Surg Today. 2008;38:453–7.CrossRefGoogle Scholar
Gotohda N, Nakagohri T, Saito N, et al. A case of anaplastic ductal carcinoma of the pancreas with production of granulocyte-colony stimulating factor. Hepatogastroenterology. 2006;53:957–9.PubMedGoogle Scholar
Fukushima N, Sasatomi E, Tokunaga O, et al. A case of pancreatic cancer with production of granulocyte colony-stimulating factor. Am J Gastroenterol. 2001;96:258–9.CrossRefGoogle Scholar
Yokoi H, Nakata M, Sawai K, et al. Intraglomerular metastasis from pancreatic cancer. Am J Kidney Dis. 2001;37:1299–303.CrossRefGoogle Scholar
Ohtsubo K, Mouri H, Sakai J, et al. Pancreatic cancer associated with granulocyte-colony stimulating factor production confirmed by immunohistochemistry. J Clin Gastroenterol. 1998;27:357–60.CrossRefGoogle Scholar
Uematsu T, Tsuchie K, Ukai K, et al. Granulocyte-colony stimulating factor produced by pancreatic carcinoma. Int J Pancreatol. 1996;19:135–9.PubMedGoogle Scholar
Kataoka K, Achiwa K, Minami Y, et al. A case of a patient with granulocyte-colony stimulating factor-producing pancreatic cancer who responded to nab-paclitaxel plus gemcitabine. Nihon Shokakibyo Gakkai Zasshi. 2017;114(7):1277–84.PubMedGoogle Scholar
Naruse H, Shimoyama N, Kudo T, et al. Autopsy of invasive ductal pancreatic carcinoma that transformed into a tumor producing granulocyte colony-stimulating factor. Nihon Shokakibyo Gakkai Zasshi. 2017;114(5):854–64.PubMedGoogle Scholar
Hayashi H, Eguchi N, Sumimoto K, et al. Autopsy of anaplastic carcinoma of the pancreas producing granulocyte colony-stimulating factor. Nihon Shokakibyo Gakkai Zasshi. 2016;113(8):1408–15.PubMedGoogle Scholar
Inoue Y, Koizumi M, Sata N, et al. A case of granulocyte-colony stimulating factor producing anaplastic carcinoma of the pancreas. Jpn J Gastroenterol Surg. 2012;45:427–33.CrossRefGoogle Scholar
Kudo M, Yamagata S, Shibahara Y, et al. A case of granulocyte colony-stimulating factor-producing anaplastic carcinoma of the pancreas. J Jpn Pancreas Soc. 2015;30:607–13.CrossRefGoogle Scholar
Masuda S, Koizumi K, Nishino T, et al. A granulocyte colony-stimulating factor-producing pancreatic adenocarcinoma treated with nab-paclitaxel plus gemcitabine chemotherapy. J Jpn Pancreas Soc. 2018;33:768–75.CrossRefGoogle Scholar
Matsumoto I, Kainuma O, Yamamoto H, et al. Adenocarcinoma of pancreas with non-suppurative fever, producing granulocyte-colony stimulating factor: a case report and literature review. J Jpn Pancreas Soc. 2010;25:585–90.CrossRefGoogle Scholar
Ikeda S, Okubo K, Shibahara H, et al. An autopsy of G-CSF-producing anaplastic carcinoma of the pancreas with impaired accumulation on FDG-PET after S-1 chemotherapy. Gan To Kagaku Ryoho. 2013;40(6):789–92.PubMedGoogle Scholar
Suzuki A, Takahashi T, Okuno Y, et al. Liver damage in patients with colony-stimulating factor-producing tumors. Am J Med. 1993;94:125–32.CrossRefGoogle Scholar
Charbit A, Malase EP, Tubiana M, et al. Relation between the pathlogical and the rate of human tumors. Eur J Cancer. 1971;7:307–17.CrossRefGoogle Scholar