A case report of granulocyte colony-stimulating factor-producing hepatocellular carcinoma that recurred after long-term
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CASE REPORT
A case report of granulocyte colony‑stimulating factor‑producing hepatocellular carcinoma that recurred after long‑term complete response Takako Nomura1 · Asahiro Morishita1 · Joji Tani1 · Kei Takuma1 · Mai Nakahara1 · Kyoko Oura1 · Tomoko Tadokoro1 · Kiyoyuki Kobayashi1 · Koji Fujita1 · Shima Mimura1 · Hideki Kobara1 · Kunihiko Tsutsui1 · Takayuki Sanomura2 · Yoshihiro Nishiyama2 · Emi Ibuki3 · Reiji Haba3 · Teppei Sakamoto4 · Hirohito Yoneyama5 · Takashi Himoto6 · Tsutomu Masaki1 Received: 27 May 2020 / Accepted: 13 September 2020 © Japanese Society of Gastroenterology 2020
Abstract The granulocyte colony-stimulating factor (G-CSF) is a glycoprotein that stimulates cell proliferation and differentiation of precursor cells in the bone marrow. Several cases of G-CSF-producing malignant tumors in various organs have been reported, but there are only nine cases of G-CSF-producing hepatocellular carcinoma (HCC) reported in the English literature. G-CSF-producing tumors grow rapidly and have a high probability of distant metastases; thus, they generally have a poor prognosis. Given that the mechanism of the carcinogenesis of G-CSF-producing HCC remains unclear, an efficient treatment strategy also remains to be elucidated. We report herein a case of G-CSF-producing HCC accompanied by leukocytosis and high serum G-CSF concentrations in the disease progression stage after long-term complete response. We also reviewed previous reports to investigate the clinical behaviors of G-CSF-producing HCC, including our case. Clinicians should consider G-CSF-producing HCC in patients with a hepatic mass and drastic leukocytosis, without any evidence of infection and blood disorders. Early diagnosis and prompt therapy, including radical resection, may provide a more favorable prognosis. Keywords Hepatocellular carcinoma · Granulocyte colony-stimulating factor · Leukocytosis
Introduction * Takako Nomura takako‑[email protected]‑u.ac.jp 1
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, 1750‑1 Ikenobe, Miki‑cho, Kita‑gun, Kagawa 761‑0793, Japan
2
Department of Radiology, Faculty of Medicine, Kagawa University, 1750‑1 Ikenobe, Miki‑cho, Kita‑gun, Kagawa 761‑0793, Japan
3
Department of Diagnostic Pathology, Kagawa University Hospital, 1750‑1 Ikenobe, Miki‑cho, Kita‑gun, Kagawa 761‑0793, Japan
4
Department of Internal Medicine, Yashima General Hospital, 2105‑17, Yashimanishi‑machi, Takamatsu, Kagawa 761‑0113, Japan
5
Department of Gastroenterology, Saint Martin’s Hospital, Tani‑machi, Sakaide, Kagawa 762‑0033, Japan
6
Department of Clinical Examination, Faculty of Health Sciences, Kagawa Prefectural University of Health Sciences, 281‑1 Hara, Mure‑cho, Takamatsu, Kagawa 761‑0123, Japan
Leukocytosis is often seen in patients with paraneoplastic syndromes and is related to granulocyte colony-stimulating factor (G-CSF) production. Robinson [1] reported that a colony-stimulating factor was found in the serum and urine in patients with malignant tumors. The granulocyte
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