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Dedifferentiated liposarcoma with leukocytosis. A case report of G-CSF-producing soft-tissue tumors, possible association with undifferentiated liposarcoma lineage.
[pleomorphic liposarcoma]
Granulocyte-colony-stimulating
factor
(
G-CSF
)
functions
as
a
hematopoietic
growth
factor
and
it
is
responsible
for
leukocytosis
.
G-CSF-producing
tumors
associated
with
leukocytosis
include
various
types
of
malignancies
.
We
report
the
case
of
a
72
-
year
-old
man
with
dedifferentiated
liposarcoma
characterized
by
dedifferentiated
components
of
malignant
fibrous
histiocytoma
(
MFH
)
-
like
features
in
addition
to
well-differentiated
lipoma
-like
liposarcoma
,
arising
from
his
upper
arm
.
Preoperative
laboratory
data
showed
leukocytosis
(
103
,
700
/
mul
)
.
The
serum
level
of
G-CSF
was
also
elevated
(
620
pg
/
ml
[
normal
,
<
8
pg
/
ml
]
)
.
Nine
days
after
the
surgery
,
the
leukocytosis
was
relieved
(
WBC
;
6
,
920
/
mul
)
and
the
elevated
serum
G-CSF
level
was
significantly
decreased
(
G-CSF
;
12
pg
/
ml
)
.
One
month
after
the
surgery
,
leukocytosis
gradually
began
to
appear
again
.
Three
months
after
the
surgery
metastatic
lung
lesions
were
confirmed
,
and
the
patient
subsequently
died
of
respiratory
problems
.
In
the
English
literature
regarding
soft
-tissue
tumors
with
leukocytosis
,
including
the
current
case
,
we
could
review
a
total
of
6
cases
of
liposarcoma
with
leukocytosis
.
The
subtype
of
these
6
liposarcoma
cases
was
undifferentiated
liposarcoma
,
comprising
dedifferentiated
liposarcoma
in
4
cases
and
pleomorphic
liposarcoma
in
2
cases
.
Since
the
only
other
soft
-tissue
tumor
that
was
associated
with
leukocytosis
was
MFH
,
and
since
MFH
is
characterized
by
the
absence
of
any
specific
differentiation
,
we
would
like
to
propose
a
possible
association
between
G-CSF-producing
soft
-tissue
tumors
and
an
undifferentiated
liposarcoma
lineage
,
such
as
dedifferentiated
liposarcoma
or
pleomorphic
liposarcoma
.
Diseases
Validation
Diseases presenting
"lipoma-like"
symptom
dedifferentiated liposarcoma
pleomorphic liposarcoma
proteus syndrome
well-differentiated liposarcoma
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