Granulocyte-colony stimulating factor-producing esophageal carcinosarcoma: a case report

Esophagus (Impact Factor: 0.74). 10/2007; 4(3):117-120. DOI: 10.1007/s10388-007-0113-0


An 80-year-old man presented at our hospital with chest oppression and vomiting. An endoscopic examination revealed a tumor
in the lower portion of the esophagus, and the patient was diagnosed as possibly having esophageal carcinosarcoma based on
a histological examination of endoscopic biopsy specimens. During the initial medical examination, the patient had a high
leukocyte count and a high level of serum granulocyte-colony stimulating factor (G-CSF). Moreover, immunohistochemical examination
revealed cells that were positive for antibodies against G-CSF. Therefore, we diagnosed the patient as possibly having a G-CSF-producing
esophageal carcinosarcoma. The patient died of tumor 4 months after the initial diagnosis.

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    ABSTRACT: A 51-year-old man was admitted to the hospital for dysphagia, pyrexia, and leukocytosis. The serum level of granulocyte-colony stimulating factor (G-CSF) was elevated. Barium esophagography and endoscopy revealed a polypoid tumor in the middle portion of the esophagus. After an esophagectomy, the leukocyte count and serum G-CSF level normalized. The pathological diagnosis was carcinosarcoma of the esophagus with two components: namely, squamous cell carcinoma and sarcoma. Moreover, cancer cells were positive for G-CSF antibody. These findings confirmed that the esophageal carcinosarcoma in this case was a G-CSF-producing tumor. Although a G-CSF-producing esophageal carcinosarcoma is very rare, this disease should be considered when a patient has symptoms such as leukocytosis and pyrexia without an associated infection.
    Esophagus 09/2008; 5(3):171-175. DOI:10.1007/s10388-008-0164-x · 0.74 Impact Factor
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    ABSTRACT: We report a case of a 69-year-old man who was diagnosed to have granulocyte colony-stimulating factor (G-CSF)-producing esophageal squamous cell carcinoma, based on a histological examination of endoscopic biopsy specimens. A high serum level of leukocytes and G-CSF was noted. Moreover, immunohistochemical examination revealed that the tumor cells were positive for antibodies against G-CSF. Palliative radiation therapy was performed because of existing distant metastasis at the time of presentation, and the patient died of tumor progression 7 months after the initial diagnosis. To the best of our knowledge, only five cases with G-CSF-producing squamous cell carcinoma have been described in the English literature, including our present case. Because many cytokines induced by G-CSF-producing tumors contribute to tumor growth and aggressive inflammation, these patients might have a poor prognosis. G-CSF-producing tumor is extremely rare; however, we should consider a differential diagnosis for such disease when a patient shows a high leukocyte count with no evidence of systemic infection or hematological disease.
    Esophagus 11/2008; 5(4):205-209. DOI:10.1007/s10388-008-0166-8 · 0.74 Impact Factor
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