著明な白血球増多と高Ca血症を伴った上顎癌の一症例 : CSF産生腫瘍

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A case, 50 year old male, of CSF (Colony Stimulating Factor) producing maxillary cancer was reported. His chief complaint was the remarkable swelling of the left cheek. Granulomatous tumor grew in the maxillary sinus and developed mainly to anterior-lateral direction. Histological diagnosis of the tumor was undifferentiated carcinoma.Laboratory data showed marked leukocytosis and hypercalcemia. The white blood cell count was 67, 400/mm3 with 91% mature neutrophils. The results of sternal puncture did not indicate any supporting findings of the leukemia. There was no apparent sign of infection except for slight fever and positive CRP.Surgical removal of the tumor resulted rapid decrease of WBC count at the level of 10, 000/mm3. The following radiation therapy also maintained it at the level of 10, 000 to 20, 000/mm3. However, a few weeks after finishing of the radiation therapy, the tumor began to growing again. And WBC count was gradually increased in parallel with tumor size. The other interesting finding was that the serum calcium level was also well correlated to the tumor growth.The results suggested that the tumor might produce some stimulating factors of leukocyte proliferation. There have been only several reports that a particular case of cancer produce so called colony stimulation factor (CSF). The authors, therefore, investigated to detect the CSF in patients urine and serum, and supernatant from short-term culture of the tumor. A higher level of CSF was detected in the urine but not in the serum and culture supernatant.From these results and clinical feature, it could be considered that this cancer was so-called CSF producing tumor.It is said that the case with CSF producing tumor commonly shows hypercalcemia, as detected in our case. The hypercalcemia in the case reported, seemed to be caused by CSF related factor.

著明な白血球増多と高Ca血症を伴った上顎癌の一症例 : CSF産生腫瘍

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