A case of granulocyte-colony stimulating factor producing gallbladder cancer

Ever since the identification of the colony-stimulating factor (CSF), granu locyte-CSF (G-CSF)-producing tumors have often been reported, and have been attracting attention, especially in pulmonary cancer. However, there have been only a small number of reports of G-CSF-producing tumors in cases of g astrointestinal cancer, and only four cases of G-CSF-producing gallbladder cancer have been reported so far. Recently, we encountered a 73-yr-old man with G-CSF-producing gallbladder cancer, The leukocyte count in the periphe ral blood increased to the maximum of 75,200/mm(3) during the course of obs ervation, and mature neutrophils accounted for 97% (segmented forms: 89%, b and forms: 8%). The serum G-CSF concentration was high (129 pg/ml), The leu kocyte count became normalized postoperatively, and the serum G-CSF concent ration also decreased (50 pg/ml), The tumor was diagnosed as undifferentiat ed adenocarcinoma of the pleomorphic type on the histopathologic examinatio n, Numerous tumor cells were stained with the anti-G-CSF antibody. Detailed findings of the patient are presented here together with some discussion o f the literature. (C) 1999 by Am. Coll. of Gastroenterology.