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Case Report
Granulocyte-colony-stimulating-factor (G-CSF) producing hepatocellular carcinoma with rapid progression: A case report
1 Center of Gastroenterology and Oncology, IMS Ota Chuo General Hospital, Ota, Japan
2 Department of General Surgery, Flash Hospital, Fujioka, Japan
3 Department of Pathology, Gunma Prefectural Cancer Center, Ota, Japan
4 Department of General Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
5 Department of General Surgery, Itabashi Chuo Medical Center, Tokyo, Japan
6 Department of Diagnostic Pathology, Dokkyo University Hospital, Japan
Address correspondence to:
Yuhei Nakano
Center of Gastroenterology and Oncology, IMS Ota Chuo General Hospital, 371-8513 875-1 Higashi-imaizumi-machi, Ota-shi, Gunma,
Japan
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Article ID: 100016G01YN2021
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Nakano Y, Ohwada S, Kashima Y, Matsuyama H, Kawate S, Iijima M, Moro A, Sasaki K, Yoshimura Y, Nakajima R, Takada-Owada A. Granulocyte-colony-stimulating- factor (G-CSF) producing hepatocellular carcinoma with rapid progression: A case report. Edorium J Gastroenterol 2021;8:100016G01YN2021.ABSTRACT
Introduction: This is a case of an 80-year-old man presented a large hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) extending to the bifurcation of the portal vein (PV). He had leukocytosis and elevated serum G-CSF. Although the patient underwent en bloc PV tumor thrombectomy followed by right hepatectomy, he died of hepatic hilar lymph nodes and multiple lung metastases two months after surgery. Pathological findings showed poorly differentiated HCC and positive G-CSF immunostaining. Clinicians are in need to note the management for HCC with concurrent G-CSF producing and PVTT. Granulocyte-colony-stimulating-factor (G-CSF) producing hepatocellular carcinoma (HCC) has been reported as a rare and poor prognosis tumor. Further, PVTT is also a poor prognostic factor in HCC. We report a case of G-CSF producing HCC with PVTT that progressed rapidly to die soon after surgery.
Case Report: An 80-year-old man presented anorexia and fatigue. Abdominal computed tomography (CT) scan showed a large liver tumor in the right lobe and PVTT extending to the bifurcation of the PV. He had leukocytosis and elevated serum G-CSF. The patient underwent en bloc PV tumor thrombectomy followed by right hepatectomy, but his leukocytosis did not normalize. He died of hepatic hilar lymph nodes and multiple lung metastases two months after surgery regardless of complete tumor removal. Pathological findings showed poorly differentiated HCC and positive G-CSF immunostaining.
Conclusion: Clinicians are in need to note the management for HCC with concurrent G-CSF producing and PVTT.
Keywords: Granulocyte-colony-stimulating-factor, Hepatocellular carcinoma, Leukocytosis, Portal vein tumor thrombus, Surgery
SUPPORTING INFORMATION
Acknowledgement
We appreciate Kenzo Okauchi, Department of Diagnostic Radiology, who supported us to diagnose as G-CSF producing HCC.
Author ContributionsYuhei Nakano - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Susumu Ohwada - Revising it critically for important intellectual content, Final approval of the version to be published
Yasushige Kashima - Analysis of data, Drafting the article, Final approval of the version to be published
Hideki Matsuyama - Analysis of data, Drafting the article, Final approval of the version to be published
Susumu Kawate - Analysis of data, Drafting the article, Final approval of the version to be published
Misa Iijima - Analysis of data, Drafting the article, Final approval of the version to be published
Amika Moro - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kazunari Sasaki - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Yukino Yoshimura - Analysis of data, Drafting the article, Final approval of the version to be published
Ryuichiro Nakajima - Analysis of data, Drafting the article, Final approval of the version to be published
Atsuko Takada-Owada - Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Yuhei Nakano et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
