A Granulocyte-colony Stimulating Factor-producing Esophageal Squamous Cell Carcinoma Treated with Chemoradiation Therapy

Abstract

The patient was a 60-year-old man who presented with dysphagia and body weight loss and in whom esophageal cancer was diagnosed by endoscopy. Biopsy showed moderately differentiated squamous cell carcinoma. Despite no evidence of infection, laboratory data showed leukocytosis (43,400/μl) and high serum levels of granulocyte-colony stimulating factor (G-CSF) (66 pg/ml). Immunohistochemical study showed positive staining for G-CSF in the tumor cells. The patient had an operation, but the tumor rapidly enlarged and invaded the aortic artery, so we decided against esophagectomy. Chemoradiation therapy (CRT) with 5-fluorouracil and cisplatin was performed and the evaluated response to treatment was a complete response. Furthermore, in this case, adjuvant chemotherapy was added. Recurrence has not been detected for seven-years and four months.