Shimamoto H, Hirota Y, Kashima Y, Kinoshita N, Yokokawa M, Ikeda T, Harada H. Granulocyte colony-stimulating factor-producing squamous cell carcinoma of the tongue exhibiting characteristic fluorine-18 deoxyglucose accumulation on positron emission tomography–computed tomography: A case report. World J Clin Cases 2020; 8(9): 1666-1673 [PMID: 32432145 DOI: 10.12998/wjcc.v8.i9.1666]
Corresponding Author of This Article
Hiroaki Shimamoto, DDS, PhD, Assistant Professor, Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1130033, Japan. hiroaki.osur@tmd.ac.jp
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Clin Cases. May 6, 2020; 8(9): 1666-1673 Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1666
Granulocyte colony-stimulating factor-producing squamous cell carcinoma of the tongue exhibiting characteristic fluorine-18 deoxyglucose accumulation on positron emission tomography–computed tomography: A case report
Hiroaki Shimamoto, Yoshihisa Kashima, Naoya Kinoshita, Misaki Yokokawa, Hiroyuki Harada, Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
Yuka Hirota, Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
Tohru Ikeda, Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8549, Japan
Author contributions: Shimamoto H and Harada H were the patient’s oral and maxillofacial surgeons, reviewed the literature and contributed to manuscript drafting; Kashima Y, Kinoshita N and Yokokawa M were the patient’s oral and maxillofacial surgeons, reviewed the literature and drafted the manuscript; Hirota Y and Ikeda T performed the pathological analysis and reviewed the literature and drafted the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Hiroaki Shimamoto, DDS, PhD, Assistant Professor, Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1130033, Japan. hiroaki.osur@tmd.ac.jp
Received: February 13, 2020 Peer-review started: February 13, 2020 First decision: February 16, 2020 Revised: April 4, 2020 Accepted: April 21, 2020 Article in press: April 21, 2020 Published online: May 6, 2020 Processing time: 77 Days and 11.1 Hours
Abstract
BACKGROUND
Granulocyte colony-stimulating factor (G-CSF) is a cytokine produced in inflammatory environments that induces differentiation and proliferation of neutrophils in bone marrow. We report a rare case of aggressive G-CSF-producing squamous cell carcinoma of the tongue exhibiting fluorine-18 deoxyglucose (FDG) accumulation in primary lesion, metastatic lymph nodes, spleen, and bone marrow on positron emission tomography–computed tomography (PET/CT).
CASE SUMMARY
We report a 58-year-old female with a rapid enlarged lingual mass with partial necrosis. Blood test results from the initial examination revealed a leukocyte count of 21380/µL. On PET/CT, extensive FDG accumulation was observed in the tongue and bilateral cervical lymph nodes, with elevated FDG accumulation in the spleen and bone marrow although no distant metastases were observed. We performed partial glossectomy and bilateral neck dissection. Immunohistochemical staining with G-CSF antibodies on biopsy specimen and resected samples revealed that both specimens were G-CSF positive. This is a rare case of G-CSF producing tongue carcinoma with elevated FDG accumulation in the spleen and bone marrow.
CONCLUSION
In patients with the tongue cancer and hyperleukocytosis, where FDG accumulations in the spleen and bone marrow are observed using PET/CT and when these accumulations are not caused by metastasis, G-CSF-producing tumors, with associated poor prognosis, should be considered.
Core tip: Tongue cancer is the most common cancer of the head and neck. But progress usually is not rapid. In addition, there is no accompanying hyperleukocytosis and no fluorine-18 deoxyglucose (FDG) accumulation in the spleen and bone marrow. Here we report a rare granulocyte colony-stimulating factor (G-CSF)-producing tongue carcinoma with rapid progression, with hyperleukocytosis, and FDG accumulation in the spleen and bone marrow on positron emission tomography–computed tomography. From this case, G-CSF-producing tumors should be suspected in tongue cancer when hyperleukocytosis and FDG accumulation in the spleen or bone marrow on positron emission tomography–computed tomography because G-CSF producing tumor progress rapidly and have a poor prognosis.
