Granulocyte colony-stimulating factor-producing hepatocellular carcinoma with abrupt changes

Area of Science:

• Oncology
• Hepatology
• Endocrinology

Background:

• Granulocyte colony-stimulating factor (G-CSF)-producing tumors are rare, presenting with fever and elevated white blood cell (WBC) counts.
• While G-CSF producing tumors occur in various cancers, G-CSF producing hepatocellular carcinoma (HCC) is exceptionally uncommon.
• This case highlights a rapidly growing, poorly differentiated HCC associated with G-CSF production.

Approach:

• Clinical case presentation of a patient with G-CSF producing HCC.
• Laboratory analysis including serum WBC, C-reactive protein (CRP), and G-CSF levels.
• Immunohistochemical analysis to confirm G-CSF overexpression in HCC cells.
• Surgical intervention (radical hepatectomy) and post-operative monitoring.

Key Points:

• The patient presented with persistent high fever, abdominal pain, and cough, accompanied by elevated serum WBC, CRP, and G-CSF.
• Radical hepatectomy resulted in complete resolution of symptoms and normalization of inflammatory markers and G-CSF levels.
• Immunohistochemistry confirmed G-CSF overexpression within the HCC cells.
• The patient remained disease-free with normal laboratory values for six months post-surgery.

Conclusions:

• G-CSF producing HCC is a rare entity with distinct clinical features.
• Radical surgical resection appears to be an effective treatment strategy for G-CSF producing HCC.
• This case contributes to the limited literature on G-CSF producing HCC, emphasizing the importance of considering G-CSF in the differential diagnosis of unexplained paraneoplastic syndromes in HCC patients.