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Shimamoto H, Hirota Y, Kashima Y, Kinoshita N, Yokokawa M, Ikeda T, Harada H. Granulocyte colony-stimulating factor-producing squamous cell carcinoma of the tongue exhibiting characteristic fluorine-18 deoxyglucose accumulation on positron emission tomography–computed tomography: A case report. World J Clin Cases 2020; 8:1666-1673. [PMID: 32432145 PMCID: PMC7211540 DOI: 10.12998/wjcc.v8.i9.1666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/04/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Granulocyte colony-stimulating factor (G-CSF) is a cytokine produced in inflammatory environments that induces differentiation and proliferation of neutrophils in bone marrow. We report a rare case of aggressive G-CSF-producing squamous cell carcinoma of the tongue exhibiting fluorine-18 deoxyglucose (FDG) accumulation in primary lesion, metastatic lymph nodes, spleen, and bone marrow on positron emission tomography–computed tomography (PET/CT).
CASE SUMMARY We report a 58-year-old female with a rapid enlarged lingual mass with partial necrosis. Blood test results from the initial examination revealed a leukocyte count of 21380/µL. On PET/CT, extensive FDG accumulation was observed in the tongue and bilateral cervical lymph nodes, with elevated FDG accumulation in the spleen and bone marrow although no distant metastases were observed. We performed partial glossectomy and bilateral neck dissection. Immunohistochemical staining with G-CSF antibodies on biopsy specimen and resected samples revealed that both specimens were G-CSF positive. This is a rare case of G-CSF producing tongue carcinoma with elevated FDG accumulation in the spleen and bone marrow.
CONCLUSION In patients with the tongue cancer and hyperleukocytosis, where FDG accumulations in the spleen and bone marrow are observed using PET/CT and when these accumulations are not caused by metastasis, G-CSF-producing tumors, with associated poor prognosis, should be considered.
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Affiliation(s)
- Hiroaki Shimamoto
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yuka Hirota
- Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Yoshihisa Kashima
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Naoya Kinoshita
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Misaki Yokokawa
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Tohru Ikeda
- Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Hiroyuki Harada
- Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
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Baseline peripheral blood leukocytosis: Biological marker predicts outcome in oropharyngeal cancer, regardless of HPV-status. Oral Oncol 2018; 78:200-206. [DOI: 10.1016/j.oraloncology.2018.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 12/14/2017] [Accepted: 02/04/2018] [Indexed: 01/12/2023]
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Kuroshima T, Wada M, Sato T, Takano M, Makino S. G-CSF producing oral carcinoma with diffuse uptake of FDG in the bone marrow: A case report. Oncol Lett 2017; 15:1241-1245. [PMID: 29399178 DOI: 10.3892/ol.2017.7422] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 11/06/2017] [Indexed: 12/27/2022] Open
Abstract
A 78-year-old male patient was referred to the Department of Oral Surgery, Hokuto Hospital (Obihiro, Japan) for painless swelling on the left neck and tongue. Histopathological examination of a biopsy specimen resulted in a diagnosis of squamous cell carcinoma of the tongue. Imaging examinations revealed cervical lymph node metastases on both sides, along with diffuse uptake of 18F-fluorodeoxyglucose (FDG) in the bone marrow of the spine and pelvis. Hematologic tests revealed an increased white blood cell (WBC) count and serum concentrations of granulocyte colony stimulating factor (G-CSF). These findings suggested a G-CSF producing tumor, with fluctuations of WBC count, serum G-CSF concentration, and FDG uptake in the bone marrow, associated with tumor shrinkage and enlargement, an indicator of tumor status.
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Affiliation(s)
- Takeshi Kuroshima
- Oral and Maxillofacial Surgery, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
| | - Mayumi Wada
- Department of Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833 Japan
| | - Takehiko Sato
- Department of Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833 Japan
| | - Masashi Takano
- Department of Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833 Japan
| | - Shujiroh Makino
- Department of Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833 Japan
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Matsumoto K, Hayakawa N, Nakamura S. Granulocyte colony-stimulating factor-producing upper urinary tract carcinoma: systematic review of 46 cases reported in Japan. Clin Oncol (R Coll Radiol) 2014; 26:781-8. [PMID: 25179323 DOI: 10.1016/j.clon.2014.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 07/10/2014] [Accepted: 08/08/2014] [Indexed: 11/30/2022]
Abstract
AIMS Granulocyte colony-stimulating factor (G-CSF)-producing upper urinary tract carcinoma is extremely rare, and we do not yet have a comprehensive understanding of the disease. This study was carried out to determine the characteristics of G-CSF-producing upper urinary tract carcinoma. MATERIALS AND METHODS A systematic MEDLINE and ICHUSHI WEB (Japan Medical Abstract Society) search was carried out to identify articles and conference proceedings describing patients with G-CSF-producing upper urinary tract carcinoma. The final cohort included 46 patients: eight studies were published in English, 16 in Japanese and there were 18 Japanese conference proceedings. RESULTS The average age of patients was 67 years and the male to female ratio was 2.5 to 1. The mean white blood cell count was as high as 33,900/μl (range 10,000-121,000) in these patients. Pretreatment serum G-CSF levels were measured in 23 patients, all of which were higher (range 55-1220 pg/ml) than normal levels. Metastasis was detected in 29 patients (63%) and lymph node and lung metastases were well observed. The most commonly reported primary treatment was surgery (33 patients), but the median survival period for these patients was short (4.5 months). Multivariate analysis showed that lymph node and/or distant metastasis (hazard ratio 2.92, P = 0.020) and the absence of adjuvant therapy (hazard ratio 3.20, P = 0.014) were independent risk factors for mortality. A total of only seven patients survived more than 1 year and most had a history of neoadjuvant/adjuvant chemotherapy and/or radiation therapy. CONCLUSION We believe that the presence of G-CSF-induced leukocytosis represents a distinct and highly aggressive form of upper urinary tract carcinoma. However, the results of our systematic review indicate that a multidisciplinary approach including surgery, neoadjuvant or adjuvant chemotherapy and radiotherapy may have the potential to control the disease, although we cannot provide definitive recommendations from this retrospective study.
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Affiliation(s)
- K Matsumoto
- Tokyo Saiseikai Central Hospital, Department of Urology, Tokyo, Japan.
| | - N Hayakawa
- Tokyo Saiseikai Central Hospital, Department of Urology, Tokyo, Japan
| | - S Nakamura
- Tokyo Saiseikai Central Hospital, Department of Urology, Tokyo, Japan
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Kobayashi JI, Miyazaki A, Yamamot T, Nakamori K, Suzuki R, Kaneko T, Suzuki N, Hiratsuka H. Granulocyte colony-stimulating factor-producing squamous cell carcinoma of the lower gingiva: a case report. HEAD & NECK ONCOLOGY 2012; 4:35. [PMID: 22713692 PMCID: PMC3414787 DOI: 10.1186/1758-3284-4-35] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 06/19/2012] [Indexed: 12/25/2022]
Abstract
The present study summarizes our experience in treating a patient with a suspected granulocyte colony-stimulating factor (G-CSF)-producing squamous cell carcinoma (SCC) of the lower gingiva, which is a rather rare entity. A 56-year-old woman underwent surgical excision of palate leukoplakia in 1996. In 2009, however, a leukoplakic superficial tumor was detected in the lower left gingiva, for which the patient underwent gingivectomy. This was subsequently diagnosed as SCC. The patient also underwent superselective arterial injection chemotherapy combined with radiotherapy, after local recurrence was observed. The patient was subsequently found to have bone metastasis. After chemotherapy combined with radiotherapy, the patient underwent segmental resection of the lower left jaw, left supraomohyoid neck dissection, and lower jaw reconstruction using titanium plates. Resection of the left femoral tumor and left total knee replacement were also performed. Computed tomography scan performed 1 month after the surgeries revealed multiple lung, liver, spine, and subcutaneous metastases. The patient also exhibited a sudden increase in her white blood cell (WBC) count and a fever that could not be alleviated, despite treatment with antibacterial drugs. A G-CSF-producing tumor was therefore suspected. Serum G-CSF level was high at 250 pg/ml. The patient's WBC count increased to 32 × 103/ml and her general condition suddenly deteriorated, and she died as a result of multiple organ failure. A final diagnosis of G-CSF-producing SCC of the lower gingiva was made based on the patient's clinical course.
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Affiliation(s)
- Jun-ichi Kobayashi
- Department of Oral Surgery, Sapporo Medical University School of Medicine, South 1,West 16, Chuo-ku Sapporo, 060-8543, Japan.
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Mabuchi S, Matsumoto Y, Isohashi F, Yoshioka Y, Ohashi H, Morii E, Hamasaki T, Aozasa K, Mutch DG, Kimura T. Pretreatment leukocytosis is an indicator of poor prognosis in patients with cervical cancer. Gynecol Oncol 2011; 122:25-32. [DOI: 10.1016/j.ygyno.2011.03.037] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 03/28/2011] [Accepted: 03/31/2011] [Indexed: 11/26/2022]
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The first 2 cases of granulocyte colony-stimulating factor producing adenocarcinoma of the uterine cervix. Int J Gynecol Pathol 2010; 29:483-7. [PMID: 20736776 DOI: 10.1097/pgp.0b013e3181d29729] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing nonhematopoietic malignancies have been reported in various organs, and most of them have been associated with poor clinical outcome. However, because of the rarity of the reported cases, information regarding the G-CSF-producing gynecological malignancies is limited. We report the first 2 cases of G-CSF-producing cervical adenocarcinomas, which exhibited an aggressive clinical course. At initial diagnosis, both patients exhibited marked leukocytosis without an obvious sign of infections. Of these, one was initially treated with definitive radiotherapy and the other was treated with radical surgery. However, both of these patients experienced recurrences in a short period and died from disease progression in less than 6 months. According to the facts that the tumor cells were positive for G-CSF, the elevated serum level of G-CSF, and their clinical course correlated well with the white blood cell count, we concluded that these tumors were G-CSF-producing cancers. These cases strongly indicate the aggressive nature of the G-CSF-producing cervical adenocarcinomas.
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Matsumoto Y, Mabuchi S, Muraji M, Morii E, Kimura T. Squamous cell carcinoma of the uterine cervix producing granulocyte colony-stimulating factor: a report of 4 cases and a review of the literature. Int J Gynecol Cancer 2010; 20:417-21. [PMID: 20375807 DOI: 10.1111/igc.0b013e3181d15a11] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing malignant tumor has been reported to occur in various organs, and most of which has been associated with poor clinical outcome. However, because of the rarity of the reported cases, information regarding the G-CSF-producing gynecological malignancies is limited. We report 4 cases of G-CSF-producing cervical cancers. At initial diagnosis, all of the 4 patients exhibited marked leukocytosis without an obvious sign of infection. Of the 4 patients, 3 had their disease initially treated with definitive radiotherapy, and one was treated with radical surgery. Despite the aggressive treatments, all of these patients experienced recurrences within 6 months. In all cases, the white blood cell count returned to the normal range in response to the initial treatment and then increased again with recurrences. Based on the facts that the tumor cells were positive for G-CSF, the serum level of G-CSF was elevated, and their clinical course correlated well with the white blood cell count, we concluded that these tumors were G-CSF-producing cancers. All patients died from disease progression in less than 15 months. These cases strongly indicate the aggressive nature of the G-CSF-producing cervical cancer.
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Affiliation(s)
- Yuri Matsumoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine. 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
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Chapireau D, Adlam D, Cameron M, Thompson M. Paraneoplastic syndromes in patients with primary oral cancers: a systematic review. Br J Oral Maxillofac Surg 2010; 48:338-44. [DOI: 10.1016/j.bjoms.2009.08.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2009] [Accepted: 08/03/2009] [Indexed: 12/11/2022]
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Nasu K, Inoue C, Takai N, Kashima K, Miyakawa I. Squamous Cell Carcinoma of the Cervix Producing Granulocyte Colony–Stimulating Factor. Obstet Gynecol 2004; 104:1086-8. [PMID: 15516405 DOI: 10.1097/01.aog.0000141552.87313.c8] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Marked leukocytosis is occasionally observed in patients with a malignant nonhematopoietic tumor. Granulocyte colony-stimulating factor (G-CSF) may be responsible for this phenomenon. We report a case of G-CSF-producing squamous cell carcinoma of the cervix that showed marked leukocytosis. CASE A 71-year-old Japanese woman was admitted for further investigation for leukocytosis. Her white blood cell (WBC) count had been gradually increasing over a period of 10 months. Laboratory data on admission revealed marked leukocytosis, with a WBC count of 30,400/microL, which consisted primarily of mature granulocytes (93%). Her serum G-CSF level was significantly elevated. However, there was no evidence of infection or hematopoietic disorders. Further examinations showed stage IIIb cervical cancer. The pathological diagnosis was squamous cell carcinoma of the nonkeratinizing type. Immunohistochemical staining of the biopsied specimens confirmed the production of G-CSF protein by the tumor cells. The patient was successfully treated by radiation therapy. Her WBC count returned to a normal level (3,700/microL). Her serum G-CSF level also decreased. The patient is alive without evidence of recurrence at 8 months after the treatment. CONCLUSION It is suggested that the leukocytosis manifested in this patient was due to G-CSF produced by the tumor. It was possible to use the WBC count and serum G-CSF levels as additional tumor markers.
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Affiliation(s)
- Kaei Nasu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Oita, Japan.
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