Abstract
Cancer of unknown primary origin (CUP) which is usually diagnosed based on the histological type of metastatic site has marked heterogeneous characteristics. Sarcomatoid carcinoma defined as CUP has not been reported according to our literature survey. A 59-year-old man presented with enlarged multiple thoracic lymph nodes, huge splenomegaly and nodules in left temporal lobe of the brain. The histopathological diagnosis of lymph node and spleen was sarcomatoid carcinoma. However, all extensive diagnostic examinations could not detect a site of primary origin. The laboratory data showed marked leukocytosis with increased serum granulocyte colony-stimulating factor (G-CSF). Therefore, the patient was finally diagnosed of CUP of sarcomatoid carcinoma producing G-CSF. After gamma knife treatment for brain metastases, two regimens of taxan-based chemotherapy (carboplatin and paclitaxel, gemcitabine and docetaxel) were administered, with no effect but further tumor progression. Splenectomy for avoiding splenic rupture was performed. As the third line chemotherapy, the combination consisting of doxorubicin and ifosfamide was administered and showed a good therapeutic effect and normalized white blood cell count and serum G-CSF level. He achieved complete remission after three cycles. Herein we present an extremely rare case of CUP of sarcomatoid carcinoma producing G-CSF. Our case suggests the importance of chemotherapy including doxorubicin and ifosfamide, and multimodal therapeutic strategy for this aggressive disease.
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References
Fizazi K, Greco FA, Pavlidis N et al (2011) Cancer of unknown primary site. ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 22((Supplement 6)):vi64–vi68
Pavlidis N, Pentheroudakis G (2012) Cancer of unknown primary site. Lancet 379:1428–1435
Yamano T, Morii E, Ikeda J et al (2007) Granulocyte colony-stimulating factor production and rapid progression of gastric cancer after histological change in the tumor. Jpn J Clin Oncol 37:793–796
Kawaguchi M, Asada Y, Terada T et al (2010) Aggressive recurrence of cancer as a granulocyte-colony-stimulating factor-producing tumor. Int J Clin Oncol 15:191–195
Bae HM, Min HS, Lee SH et al (2007) Palliative chemotherapy for pulmonary pleomorphic carcinoma. Lung Cancer 58:112–115
Hong JY, Choi MK, Uhm JE et al (2009) The role of palliative chemotherapy for advanced pulmonary pleomorphic carcinoma. Med Oncol 26:287–291
Sato S, Koike T, Yamato Y et al (2010) A case of rapid growing pulmonary carcinosarcoma. Int J Clin Oncol 15:319–324
Georgoulias V, Kouroussis C, Androulakis N et al (1999) Front-line treatment of advanced non-small cell lung cancer with docetaxel and gemcitabine: a multicenter phase II trial. J Clin Oncol 17:914–920
Hensley ML, Maki R, Venkatraman E et al (2002) Gemcitabine and docetaxel in patients with unresectable leiomyosarcoma: results of a phase II trial. J Clin Oncol 20:2824–2831
Lee KW, Kim YJ, Kim JH et al (2011) Two consective cases of platinum-refractory pulmonary pleomorphic carcinoma that showed dramatic responses to MAID (Mesna, Doxorubicin, Ifosfamide and Dacarbazine) chemotherapy. Jpn J Clin Oncol 41:430–433
Worden FP, Taylor JMG, Biermann JS et al (2005) Randomized phase II evaluation of 6 g/m2 of ifosfamide plus Doxorubicin and granulocyte colony-stimulating factor (G-CSF) compared with 12 g/m2 of ifosfamide plus doxorubicin and G-CSF in the treatment of poor-prognosis soft tissue sarcoma. J Clin Oncol 23:105–112
Kataoka K, Tanaka K, Mizusawa J et al (2014) A randomized phase II/III trial of perioperative chemotherapy with adriamycin plus ifosfamide versus gemcitabine plus docetaxel for high-grade soft tissue sarcoma: Japan Clinical Oncology Group Study JCOG1306. Jpn J Clin Oncol 44:765–769
Obermueller E, Vosseler S, Fusenig NE et al (2004) Cooperative autocrine and paracrine functions of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor in the progression of skin carcinoma cells. Cancer Res 64:7801–7812
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Karasuno, T., Nishiura, N., Kuwayama, M. et al. Dramatic response of chemotherapy for cancer of unknown primary origin of sarcomatoid carcinoma producing granulocyte colony-stimulating factor. Int Canc Conf J 5, 48–52 (2016). https://doi.org/10.1007/s13691-015-0224-8
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DOI: https://doi.org/10.1007/s13691-015-0224-8