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World J Clin Oncol. Oct 10, 2016; 7(5): 380-386
Published online Oct 10, 2016. doi: 10.5306/wjco.v7.i5.380
Granulocyte colony-stimulating factor-producing hepatocellular carcinoma with abrupt changes
Hiroaki Nagata, Shuhei Komatsu, Wataru Takaki, Tokunari Okayama, Yasunori Sawabe, Michiaki Ishii, Mitsuo Kishimoto, Eigo Otsuji, Hiroshi Konosu
Hiroaki Nagata, Shuhei Komatsu, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan
Hiroaki Nagata, Wataru Takaki, Tokunari Okayama, Yasunori Sawabe, Hiroshi Konosu, Department of Surgery, Ayabe City Hospital, Kyoto 623-0011, Japan
Michiaki Ishii, Department of Gastroenterology, Ayabe City Hospital, Kyoto 623-0011, Japan
Mitsuo Kishimoto, Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto 602-0855, Japan
Author contributions: All the authors contributed to the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shuhei Komatsu, MD, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-0855, Japan. skomatsu@koto.kpu-m.ac.jp
Telephone: +81-75-2515527 Fax: +81-75-2515522
Received: April 20, 2016
Peer-review started: April 22, 2016
First decision: June 12, 2016
Revised: August 17, 2016
Accepted: August 30, 2016
Article in press: August 31, 2016
Published online: October 10, 2016
Processing time: 172 Days and 6.2 Hours
Abstract

Granulocyte colony-stimulating factor (G-CSF)-producing tumor is one of the rare types of cancer clinically characterized by an elevated fever and white blood cell (WBC) increment. Although G-CSF producing tumors have been reported in several types of cancer including those of the lungs, cervix and bladder, G-CSF producing hepatocellular carcinoma is extremely rare. Here, we report the case of a rapidly growing and poorly differentiated hepatocellular carcinoma producing G-CSF. The patient showed symptoms of continuous high fever, stomach pain and cough, and high serum WBC counts, C-reactive protein (CRP) and G-CSF levels were found in laboratory tests. After a radical hepatectomy, the patient completely recovered from the above symptoms and inflammatory state. The serum levels of G-CSF were reduced to normal levels after radical surgery. An immunohistochemical analysis revealed the overexpression of G-CSF in the cytoplasm of certain hepatocellular carcinoma (HCC) cell. The patient’s serum WBC, CRP and G-CSF levels remained within normal levels in the six months after surgery without recurrence. This is the 9th case report of G-CSF producing hepatocellular carcinoma in English literature. We review the clinical characteristics of the G-CSF producing HCC and discuss a possible treatment strategy.

Keywords: Granulocyte colony stimulating factor; Granulocyte colony-stimulating factor producing tumor; Hepatocellular carcinoma; Immunohistochemistry; Sarcomatous changes

Core tip: Granulocyte colony-stimulating factor (G-CSF)-producing tumor is one of the rare types of cancer clinically characterized by an elevated fever and white blood cell increment. Although G-CSF producing tumors have been reported in several types of cancer including those of the lungs, cervix and bladder, G-CSF producing hepatocellular carcinoma (HCC) is extremely rare. This is the 9th case report of G-CSF producing HCC in English literature. We report our case and review reported literatures with special reference to the clinical characteristics of the G-CSF producing HCC and a possible treatment strategy.