G-CSF産生膀胱癌の1例 : 本邦症例の検討を加えて

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We report a case of urinary bladder cancer that produced granulocyte-colony stimulating factor (G-CSF). A 56-year-old man was admitted to our hospital with the chief complaint of macroscopic hematuria. Cystoscopy demonstrated a thumb tip-sized bladder tumor. Computerized tomography and magnetic resonance imaging showed muscular invasion in the bladder, but no distant metastases. The complete blood count and laboratory examination showed leukocytosis of 25,200/mm3 and a high G-CSF level of 145 pg/ml in the peripheral blood. Although he underwent total cystectomy and adjuvant chemotherapy using methotrexate, vinblastine, doxorubicin and cis-platinum (M-VAC) under the diagnosis of locally advanced bladder cancer, he died of progressive disease of the carcinoma about eight months after the diagnosis. A temporary decrease of white blood cell count and serum GCSF were observed just after treatment. The histopathological diagnosis was undifferentiated giant and spindle cell carcinoma of the urinary bladder (grade 3, pT3b, pN1). The tumor cells exhibited positive staining for G-CSF immunohistochemically.
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