A case of aggressively growing ovarian carcinoma producing G-CSF

Abstract

Granulocyte-colony stimulating factor (G-CSF)-producing tumors are a relatively rare gynecological condition. We report a rare case of undifferentiated ovarian carcinoma producing G-CSF. The patient was a 47-year-old nulliparous woman who came to our hospital complaining of fever and abdominal pain. Upon examination, her white blood cell count was found to be high (21130/μl). A contrast enhanced CT image suggested localized peritonitis resulting from a perforated sigmoid colon carcinoma. We performed partial resection of the sigmoid colon, partial resection of the small intestine, total abdominal hysterectomy, and bilateral salpingo-oophorectomy. The pathological diagnosis was an invasion of undifferentiated ovarian carcinoma. Since the patient had cerebral palsy, she didn’t undergo chemotherapy. Her white blood cell count was found to have decreased postoperatively. Three months after the operation, intraperitoneal tumors were discovered. With the recurrence of carcinoma, the patient’s white blood cell count increased until it reached 158930/μl. She died six months after surgery. From the considerable leukocytosis at the recurrence, the postoperative decrease in the white blood cell count, and the pathological diagnosis made during autopsy, we identified the tumor as an undifferentiated ovarian carcinoma producing G-CSF. We suggest that a diagnosis of G-CSF-producing carcinoma should be considered in cases of carcinoma with considerable leukocytosis. [Adv Obstet Gynecol, 66 (1) : 36-42, 2014 (H26.2)]