Abstract
A 29-year-old man presented with dysphagia. Upper gastrointestinal endoscopy revealed a type-2 gastric cancer ; based on the pathology of a biopsy specimen, a moderately differentiated adenocarcinoma was diagnosed. Laboratory tests indicated leukocytosis (38,800/μl), but no evidence of infection was observed. The serum granulocyte-colony stimulating factor (G-CSF) level was elevated, thus a G-CSF-producing gastric cancer was suspected. A total gastrectomy was performed. On pathology, the tumor was T4a(SE), N2, H0, P0, CY0, M0, Stage III B, and G-CSF immunohistochemical staining was positive. After the operation, both the leukocyte count and the serum G-CSF level decreased. Metastases in the liver and lymph nodes were detected 3 months after surgery. Chemotherapy (1st : TS-1/docetaxel, 2nd : CDDP/CPT- 11) proved ineffective, and the patient died 7 months after surgery ; his highest leukocyte count level was 148,800/μl.
