Abstract
Various hormones and cytokines produced by malignant tumors are known to cause paraneoplastic syndrome, but also a neutrophilic hematogenic factor, known as granulocyte colony stimulating factor (G-CSF), is another factor that induces paraneoplastic syndrome.
We report a case of an 82-year-old male who was diagnosed with a G-CSF producing carcinoma of the right nasal cavity. The pathology of the specimen from the biopsy revealed a well differentiated squamous cell carcinoma, and his blood/laboratory test on admittance showed a remarkable increase in WBC count of 23.7 × 109/L, as well as an extremely high level of G-CSF of 480 pg/ml. The patient underwent partial maxillectomy whereby total resection was achieved, and post-operative radiotherapy of 50 Gy in doses was applied. The serum G-CSF concentration was seen to normalize after treatment.
From these clinical findings and immunohistological results (obtained by using polyclonal antibody against G-CSF to stain the tumor cells), the tumor was diagnosed as a G-CSF producing carcinoma. The prognosis of this carcinoma is said to be very poor, averaging around 3 months, but our case has shown no recurrence for over 2 years after treatment. The fact that we were able to totally resect the tumor surgically is likely to be the most significant factor of non-recurrence. There have been reports that an increase in WBC count may be a marker of recurrence, so we plan to continue following this case carefully.
