Abstract
Malignant tumors rarely cause leukocytosis by producing granulocyte-colony stimulating factor （G-CSF）. In this report, we describe a case of G-CSF-producing tongue cancer that developed rapidly and manifested after recurrence. An 83-year-old woman presented with a chief complaint of a mass on the left lateral border of the tongue. Squamous cell carcinoma was revealed by histopathological examination, and a left partial glossectomy was performed 1 month after the initial diagnosis. Contrast-enhanced computed tomography performed 4 months after surgery revealed metastasis in the left mid internal jugular node region, and a left radical neck dissection was performed. The histopathological examination revealed one metastatic lymph node with intracapsular invasion. Six months after the neck dissection, a recurrence was observed in the left neck, with involvement of the periphery of the carotid artery and skin of the neck. Further surgery was not indicated, and chemoradiotherapy was planned; however, the disease rapidly progressed, and the patient died 13 months after treatment initiation. The white blood cell count was within normal range until the cervical recurrence, but high afterward, ranging from 16,000 to 25,000/μl. Immunohistochemical staining with anti-G-CSF monoclonal antibody was positive in all biopsy, primary resection, and metastatic lymph node specimens. Based on these findings, we diagnosed this as a G-CSF-producing tumor that became apparent after cervical recurrence.
