Granulocyte colony-stimulating factor-producing intrahepatic adenosquamous carcinoma

Abstract

Granulocyte colony-stimulating factor (G-CSF)-producing biliary tract cancer is rare and has a poor prognosis. We report a resected case of G-CSF-producing intrahepatic cholangiocarcinoma with early recurrence and rapid tumor progression. An 80-year-old man was referred to our hospital with a hepatic mass. We diagnosed intrahepatic cholangiocarcinoma and performed radical liver resection. Pathologically, the tumor was adenosquamous carcinoma, a rare subtype of intrahepatic cholangiocarcinoma. Two months after resection, multiple liver recurrences were detected, although adjuvant chemotherapy was administered. Simultaneously, he presented with a high fever, leukocytosis, and elevated C-reactive protein levels without any infection, and the symptoms gradually worsened despite the administration of antimicrobial drugs. Immunohistochemical staining revealed that the resected tumor cells were positive for G-CSF. He received another chemotherapy regimen; however, the liver metastases grew rapidly, and he died 5 months after liver resection.