2021 Volume 54 Issue 8 Pages 563-570
A 63-year old woman was admitted to our hospital due to appetite loss and persistent left abdominal pain. Laboratory data showed severe leukocytosis with elevated white blood cells (WBCs) (76,900/mm3). Transverse colon cancer was diagnosed based on CT and colonoscopy. There were no findings suggestive of infections or blood malignancy, but granulocyte-colony stimulating factor (G-CSF) was elevated to 340 pg/ml. Thus, colon cancer with production of G-CSF was suspected. Left colectomy, pancreatic tail resection and splenectomy with covering ileostomy were performed. Pathological findings indicated that the tumor was adenocarcinoma that was immunohistochemically positive for G-CSF. The serum G-CSF level and WBC count decreased to normal ranges after the operation. The final diagnosis was G-CSF-producing colon cancer. On postoperative day 21, the WBC count increased to 17,500/mm3 and CT revealed liver metastasis. Systemic chemotherapy was administered, but the patient died 14 months after the operation. We present this case as an extremely rare example of G-CSF-producing colon cancer as a tumor with a poor prognosis.
