A case of granulocyte-colony stimulating factor producing gastric cancer presenting with gastric submucosal tumor-like appearance on endoscopy

Abstract

A 68-year-old man was admitted to our hospital with anorexia and weight loss. Hematology showed marked leukocytosis (95,620/µl).
Esophagogastroduodenoscopy (EGD) revealed a large raised lesion with the appearance of a gastric submucosal tumor on the anterior gastric wall at the lesser curvature. Laboratory data revealed a high serum level of granulocyte-colony stimulating factor (G-CSF)(584 pg/ml). CT scan showed multiple liver metastases and generalized lymph node metastases. Although a submucosal tumor was suspected based on endoscopic appearance, pathological diagnosis was of a non-solid type poorly differentiated adenocarcinoma. Positive G-CSF immunological staining characterized the tumor as a G-CSF-producing gastric cancer.
Despite chemotherapy, the patient died on day 45 after admission.