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[Bladder carcinoma producing granulocyte colony stimulating factor (G-CSF). A case report]
A Akiyama1, Y Ohkubo, F Hokoishi
1Department of Urology, Tokyo Medical College Kasumigaura Hospital.
Summary
A rare case of bladder cancer producing granulocyte colony-stimulating factor (G-CSF) led to severe leukocytosis and cachexia. This finding highlights a critical, though infrequent, complication of recurrent bladder carcinoma.
Area of Science:
- Oncology
- Hematology
Background:
- Recurrent bladder carcinoma can present with unusual paraneoplastic syndromes.
- Bladder cancer recurrence post-cystectomy requires vigilant monitoring for complications.
Observation:
- A 69-year-old woman presented with fatigue, abdominal pain, and a palpable mass three months after cystectomy for invasive bladder cancer.
- Imaging revealed a large pelvic mass with suspected intestinal invasion and ileus.
- Laboratory tests showed extreme leukocytosis (79,700/mm3) and elevated serum granulocyte colony-stimulating factor (G-CSF) levels (240 pg/ml).
Findings:
- Autopsy confirmed recurrent bladder carcinoma with positive immunohistochemical staining for G-CSF.
- Bone marrow examination revealed reactive granulocytic proliferation.
- The patient's condition rapidly deteriorated, leading to death from cachexia.
Implications:
- This case represents the 8th documented instance of a G-CSF producing bladder tumor in Japanese literature.
- G-CSF producing tumors, while rare, can cause significant leukocytosis and contribute to a poor prognosis.
- Understanding this rare paraneoplastic phenomenon is crucial for diagnosing and managing complex cases of recurrent bladder cancer.