Abstract
Background. Granulocyte colony-stimulating factor (G-CSF)-producing tumor is associated with leukocytosis and a poor prognosis. Case. The comprehensive evaluation of a 55-year-old woman revealed a right upper lobe mass with chest wall infiltration and leukocytosis. A histological examination following right upper lobectomy with chest wall resection revealed G-CSF-producing pulmonary pleomorphic carcinoma. Her disease was judged to be pathological stage IIB (T3bN0M0). Leukocytosis persisted after the surgery for two months. A further examination revealed wall thickening limited to the small intestine, so enterectomy was performed, which revealed a metastatic lesion. Leukocytosis was subsequently normalized. We administered four courses of systemic chemotherapy consisting of carboplatin, paclitaxel, and bevacizumab. In addition, we administered bevacizumab-based maintenance chemotherapy for 50 cycles. Although G-CSF-producing lung carcinomas are associated with poor prognoses, she remained free of recurrence for five years after surgery. Conclusion. In the present case, surgery and bevacizumab-based systemic and maintenance chemotherapy may have been effective against G-CSF-producing pulmonary pleomorphic carcinoma.
