Sakamoto Akio, Yamamoto Hidetaka, Tanaka Kazuhiro, Matsuda Shuichi, Harimaya Katsumi, Oda Yoshinao, Tsuneyoshi Masazumi, Iwamoto Yukihide
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
World J Surg Oncol. 2006 Jul 4;4:37. doi: 10.1186/1477-7819-4-37.
G-CSF is known to function as a hematopoietic growth factor and it is known to be responsible for leukocytosis. G-CSF-producing tumors associated with leukocytosis include various types of malignancies.
We report the case of a 72-year-old man with dedifferentiated chondrosarcoma characterized by dedifferentiated components of malignant fibrous histiocytoma- or osteosarcoma-like features in addition to conventional chondrosarcoma, arising from his pelvic bone. After hemipelvectomy, when local recurrence and metastasis were identified, leukocytosis appeared and an elevated level of serum granulocyte-colony-stimulating factor (G-CSF) was also recognized. The patient died of multiple organ failure 2 months after surgery. Autopsy specimens showed that the histological specimens of the recurrence and metastasis were dedifferentiated components, without any conventional chondrosarcoma components. G-CSF was expressed only in the dedifferentiated components, not in the chondrosarcoma components, immunohistochemically.
This is the first report of chondrosarcoma, or any other primary bone tumor, with leukocytosis, probably stimulated by tumor-produced G-CSF from the dedifferentiated components.
已知粒细胞集落刺激因子（G-CSF）作为一种造血生长因子发挥作用，并且已知其与白细胞增多有关。与白细胞增多相关的产生G-CSF的肿瘤包括各种类型的恶性肿瘤。
我们报告了一例72岁男性去分化软骨肉瘤病例，该肿瘤除了常规软骨肉瘤外，还具有恶性纤维组织细胞瘤或骨肉瘤样特征的去分化成分，起源于骨盆骨。半骨盆切除术后，当发现局部复发和转移时，出现了白细胞增多，同时血清粒细胞集落刺激因子（G-CSF）水平也升高。患者术后2个月死于多器官功能衰竭。尸检标本显示，复发和转移的组织学标本为去分化成分，没有任何常规软骨肉瘤成分。免疫组织化学显示，G-CSF仅在去分化成分中表达，而不在软骨肉瘤成分中表达。
这是首例关于软骨肉瘤或任何其他原发性骨肿瘤伴白细胞增多的报告，可能是由去分化成分产生的肿瘤源性G-CSF刺激所致。
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