Sohda Tetsuro, Shiga Hiroshi, Nakane Hidetoshi, Watanabe Hiroshi, Takeshita Morishige, Sakisaka Shotaro
Third Department of Medicine, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Int J Clin Oncol. 2006 Jun;11(3):246-9. doi: 10.1007/s10147-006-0560-y.
A 56-year-old man was admitted to our hospital because of consciousness disturbance. Abdominal computed tomography revealed a large low-density tumor in the left lobe of the liver. He presented with marked leukocytosis and hypercalcemia with high levels of serum granulocyte-colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTH-rP). A diagnosis of cholangiocellular carcinoma (CCC) of the liver was confirmed by histological examination of an autopsy specimen. The tumor cells showed positivity for both G-CSF and PTH-rP with immunohistochemical staining. These results suggest that the tumor was producing both G-CSF and PTH-rP. This paraneoplastic G-CSF and PTH-rP production caused by CCC is very rare. Such cases must be followed up carefully, since tumors associated with paraneoplastic syndrome progress rapidly, resulting in a poor prognosis.
一名56岁男性因意识障碍入院。腹部计算机断层扫描显示肝脏左叶有一个大的低密度肿瘤。他表现为明显的白细胞增多和高钙血症，血清粒细胞集落刺激因子（G-CSF）和甲状旁腺激素相关蛋白（PTH-rP）水平升高。尸检标本的组织学检查证实为肝内胆管细胞癌（CCC）。免疫组织化学染色显示肿瘤细胞对G-CSF和PTH-rP均呈阳性。这些结果表明肿瘤同时产生G-CSF和PTH-rP。由CCC引起的这种副肿瘤性G-CSF和PTH-rP产生非常罕见。此类病例必须仔细随访，因为与副肿瘤综合征相关的肿瘤进展迅速，预后较差。
