An autopsy case of anaplastic ductal carcinoma of the pancreas producing granulocyte-colony stimulating factor

Abstract

A 72-year-old man visited a nearby hospital because of diarrhea. An abdominal tumor was detected, and he was referred to our hospital. An abdominal CT showed a tumor extending from the uncus of the pancreas around to the superior mesenteric artery. Such tumor markers as CA19-9 and DUPAN-2 were within normal limits. A tumor biopsy was performed under laparotomy for a definite diagnosis, and histological findings revealed anaplastic ductal carcinoma of the pancreas. Based on the diagnosis, we started chemotherapy using S-1. However, his condition was complicated with obstructive jaundice, and we therefore performed percutaneous transhepatic biliary drainage (PTBD). Despite a reduction of jaundice, the tumor progressed rapidly, and he died. With progress of the carcinoma, peripheral leukocyte count increased to 93400/μl and serum G-CSF concentration increased to 312pg/ml. Immunohistochemical staining of the autopsied specimen showed the presence of G-CSF in tumor cells, and a diagnosis of anaplastic ductal carcinoma of the pancreas producing G-CSF was made.