A case of G-CSF producing maxillary gingival carcinoma with diffuse uptake of FDG in the bone marrow of the spine and pelvis

Abstract

We report a case of maxillary gingival carcinoma producing granulocyte colony-stimulating factor （G-CSF） with diffuse uptake of FDG in the bone marrow of the spine and pelvis. A 65-year-old male was referred to our department with the chief complaint of a granulated mass in the left maxillary gingiva. Pathological examination of a biopsy specimen resulted in a diagnosis of squamous cell carcinoma of the maxillary gingiva. Blood testing revealed an increased white blood cell （WBC） count and serum concentrations of G-CSF. FDG-PET scanning showed diffuse uptake of FDG in the bone marrow of the spine and pelvis. These findings suggested a G-CSF producing tumor. Thirty days after the initial presentation, tumor resection was performed under general anesthesia. Postoperatively, the patient’s WBC count and serum concentrations of G-CSF soon decreased. Locoregional recurrence was detected 5 months after surgery, and the patient died 11 months postoperatively. FDG-PET findings are useful in the diagnosis of G-CSF producing tumor.