Abstract
A 71-year-old man complaining of inappetence and epigastralgia was found to have a gastric tumor and was admitted to our hospital. Gastrointestinal endoscopy revealed hemorrhagic type 3 gastric cancer on the antrum of the stomach, and the biopsy specimen revealed squamous cell carcinoma. Although laboratory data revealed leukocytosis (21,600/μl), we could not detect any infection focus, and serum granulocyte-colony stimulating factor (G-CSF) was high (277 pg/ml). Abdominal computed tomography (CT) revealed a 6-cm metastatic lesion in the liver, which exhibited ring enhancement. We performed distal gastrectomy and cholecystectomy to arrest bleeding from the tumor and to retain ingestion. Histopathological findings revealed adenosquamous carcinoma, and immunohistochemical staining was positive for G-CSF monoclonal antibody. According to these findings, a diagnosis of gastric adenosquamous carcinoma producing G-CSF was made. In accordance with the patient's wishes, we did not perform chemotherapy, and he died 7 weeks after surgery. G-CSF-producing gastric cancer is rare, and we have summarized the reported cases of G-CSF-producing gastric cancer in Japan.
