A case of adenosquamous cell carcinoma of the gallbladder producing G-CSF with diffusely uptake in the spine by FDG-PET

Abstract

The patient who was a man in his late 50s had a history of bladder cancer with no sign of recurrence. Blood tests showed severe inflammatory reaction. On CT, a tumorous lesion 80 mm in diameter with irregular borders was depicted extending continuously from the gall bladder fundus to the liver. FDG-PET showed markedly high uptake by the tumor, with diffuse uptake present in the spine. Cytological testing of the gallbladder by ERCP detected squamous cell carcinoma. As the elevated white blood cell count did not improve even after placement of ENBD, and FDG-PET findings, G-CSF-producing carcinoma was diagnosed (G-CSF 119 pg/ml). The patient underwent chemotherapy, but died after 6 months. Autopsy showed adenosquamous cell carcinoma, mainly in the gallbladder and liver, with tumor cells positive for G-CSF. No tumor invasion of the spine was evident, with only hyperplastic changes.