A case of resected anaplastic carcinoma of the pancreas producing granulocyte-colony stimulating factor with literature review.

IF 0.7 Q4 SURGERY
Norio Kubo, Shigemasa Suzuki, Takahiro Seki, Shunsaku Furuke, Naoki Yagi, Takashi Ooki, Ryusuke Aihara, Akira Mogi, Yuka Yoshida, Kenji Kashiwabara, Yasuo Hosouchi, Ken Shirabe
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Abstract

Background: Granulocyte colony-stimulating factor (G-CSF)-producing tumors have been reported in various organs, and the prognosis of patients with G-CSF-producing pancreatic cancers is particularly dismal. In this report, we present a case of G-CSF-producing anaplastic carcinoma of the pancreas (ACP), characterized by early postoperative recurrence and rapid, uncontrolled growth.

Case presentation: A 74-year-old man presented to our hospital with complaints of abdominal fullness and pain after eating. On admission, it was observed that the peripheral leukocyte counts and serum G-CSF levels were significantly elevated (23,770/µL and 251 pg/mL, respectively). Computed tomography of the abdomen revealed a pancreatic head tumor involving the superior mesenteric vein. Pathologically, ultrasound-guided fine-needle aspiration confirmed ACP. Subsequently, we performed a subtotal stomach-preserving pancreaticoduodenectomy with portal vein reconstruction and partial transverse colon resection. On postoperative day (POD) 7, the leukocyte count decreased from 21,180/μL to 8490/μL; moreover, computed tomography revealed liver metastasis. Therefore, mFOLFILINOX chemotherapy was initiated on POD 30. However, the tumor exhibited rapid progression, and the patient died on POD 45.

Conclusions: G-CSF-producing ACP is rare, and the prognosis of patients is extremely poor. Basic research is required to develop effective drugs against G-CSF-producing tumors, and large-scale studies using national databases are needed to develop multidisciplinary treatment methods.

一例产生粒细胞集落刺激因子的胰腺无细胞癌切除病例及文献综述。
背景:各种器官中都有产生粒细胞集落刺激因子(G-CSF)肿瘤的报道,而产生G-CSF的胰腺癌患者的预后尤其令人沮丧。在本报告中,我们介绍了一例产生 G-CSF 的胰腺无细胞癌(ACP),其特点是术后早期复发,生长迅速且不受控制:一名 74 岁的男性因主诉进食后腹部饱胀和疼痛来我院就诊。入院时发现外周血白细胞计数和血清 G-CSF 水平明显升高(分别为 23,770 个/μL 和 251 pg/mL)。腹部计算机断层扫描显示,胰头肿瘤累及肠系膜上静脉。超声引导下细针穿刺病理证实为 ACP。随后,我们进行了保留胃的胰十二指肠次全切除术,同时进行了门静脉重建和部分横结肠切除。术后第 7 天(POD),白细胞计数从 21180/μL降至 8490/μL;此外,计算机断层扫描发现肝转移。因此,患者于 POD 30 开始接受 mFOLFILINOX 化疗。然而,肿瘤迅速恶化,患者于POD 45死亡:结论:产生G-CSF的ACP非常罕见,患者的预后极差。结论:产G-CSF的ACP非常罕见,患者预后极差,需要进行基础研究,以开发针对产G-CSF肿瘤的有效药物,并利用国家数据库进行大规模研究,以开发多学科治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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