Radical esophagectomy for a 92-year-old woman with granulocyte colony-stimulating factor-producing esophageal squamous cell carcinoma: a case report

World J Surg Oncol. 2016 Oct 13;14(1):264. doi: 10.1186/s12957-016-1023-1.

Abstract

Background: Granulocyte colony-stimulating factor (G-CSF)-producing esophageal squamous cell carcinoma (ESCC) has been considered to have a poor prognosis. We successfully treated a case of G-CSF-producing ESCC in a 92-year-old woman.

Case presentation: A 92-year-old woman was admitted to our hospital with the complaints of choking while swallowing and dysphagia. Esophagogastroduodenoscopy and contrast-enhanced computed tomography revealed a type 2 esophageal cancer located 26-35 cm from the dental arch, with no distant metastasis. The patient was diagnosed with G-CSF-producing ESCC based on remarkable leukocytosis and high G-CSF levels. The patient underwent radical subtotal esophagectomy. Subsequently, the level of neutrophils (from 23,500/μL to 5000/μL) and the level of G-CSF (from 131 to <19.5 pg/mL) decreased significantly. Immunohistochemistry analysis of the resected tissue specimen showed positive staining for G-CSF in the cytoplasm of the tumor cells. Although the patient developed aspiration pneumonitis, after antibiotic treatment, she promptly recovered and was discharged.

Conclusions: Herein, we describe a case of successfully treated G-CSF-producing ESCC in a 92-year-old woman. Precise detection and safely performed immediate radical operation are considered essential to achieve a good clinical course.

Keywords: Esophageal squamous cell carcinoma; Granulocyte colony-stimulating factor; Granulocyte colony-stimulating factor-producing esophageal squamous cell carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Airway Obstruction / etiology
  • Anti-Bacterial Agents / therapeutic use
  • Biomarkers, Tumor / blood
  • Biopsy
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / metabolism*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Contrast Media / administration & dosage
  • Deglutition Disorders / etiology
  • Dental Arch
  • Endoscopy, Digestive System
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / metabolism*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophageal Squamous Cell Carcinoma
  • Esophagectomy / methods*
  • Female
  • Granulocyte Colony-Stimulating Factor / blood*
  • Granulocyte Colony-Stimulating Factor / metabolism*
  • Humans
  • Immunohistochemistry
  • Leukocyte Count
  • Neoplasm Staging
  • Neutrophils
  • Operative Time
  • Pneumonia, Aspiration / drug therapy
  • Prognosis

Substances

  • Anti-Bacterial Agents
  • Biomarkers, Tumor
  • Contrast Media
  • Granulocyte Colony-Stimulating Factor