Granulocyte-colony stimulating factor-producing gallbladder carcinoma.

[carcinoma of the gallbladder]

Abstract A 78 -year -old man was admitted to our hospital with right upper abdominal pain and fever . His general condition was poor . The laboratory data showed severe inflammatory reactions . Computed tomography revealed an irregular tumor in the gallbladder . (18 )F-fluorodeoxy-glucose positron emission tomography (FDG-PET ) showed high uptake by the tumor , with diffuse uptake in the spine . Based on the elevated leukocyte count and FDG-PET findings , a granulocyte-colony stimulating factor (G-CSF )-producing tumor was diagnosed (G-CSF 120 pg /mL ). We performed cholecystectomy with central bisegmentectomy of the liver , lymph node dissection and right hemicolectomy . Histologically , the tumor was an adenosquamous cell carcinoma of the gallbladder . Immunohistochemical staining of the tumor cells was positive for G-CSF . Postoperatively , the general condition of the patient was improved . The fever subsided , the leukocyte count and serum G-CSF level normalized , and FDG-PET showed no uptake in the spine postoperatively . The patient showed no signs of recurrence at 27 months after undergoing surgery . FDG-PET is a useful method for diagnosing G-CSF-producing gallbladder carcinoma . Aggressive curative resection for G-CSF-producing gallbladder carcinoma may improve patients ' general condition and prognosis .