Abstract
A 72-year-old man was admitted to our hospital complaining of hematochezia. Colonoscopic examination revealed a cancer in the lower rectum. Computed tomography revealed para-aortic lymphadenopathy and stenosis of the left ureter. We performed loop colostomy to avoid intestinal obstruction. Postoperatively, leukocytosis continued without any evidence of infection. Serum levels of granulocyte-colony stimulating factor (G-CSF) were noted to be elevated (280 pg/ml). Immunohistochemical study showed positive staining for G-CSF in tumor cells of a metastatic lymph node. We determined that the cancer was producing G-CSF. We initiated chemotherapy (FOLFOX6 and bevacizumab), but his general condition deteriorated and he died 2 months after surgery.
