Abstract
A 75-year-old man admitted for fever, general fatigue, and loss of appetite in June 2002 had been treated forlung carcinoma by right lobectomy in June 2001 and partial gastrectomy 8 month later elsewhere. Histopathologicalexamination showed poorly differentiated squamous cell carcinoma in the lung and a metastatic lesionin the stomach. An upper gastrointestinal series and gastroscopy showed a protruded lesion in the gastriccardia. Suspecting malignant GIST or a metastatic tumor, we conducted proximal partial gastrectomy.Histopathologically the tumor had metastasized from lung carcinoma. Immunohistochemical staining withanti-G-CSF monoclonal antibody was positive in the lung stomach and preoperative serum G-CSF was abnormallyhigh. The diagnosis was relatively rare G-CSF-producing metastatic gastric cancer. A mesenteric tumorof the transverse colon growing for a short time was resected in December 2002. Histopathological examinationand Immunohistochemical staining with anti-G-CSF monoclonal antibody showed similar results. G-CSFproducinglung carcinoma with gastric metastasis has a dismal prognosis, and surgical treatment must becarefully selected considering the patient's quality of life.
