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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
.
Diseases
Validation
Diseases presenting
"elevated leukocyte count"
symptom
carcinoma of the gallbladder
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