Ozawa Noritaka, Doi Shinpei, Tsujikawa Takayuki, Mabuchi Masatoshi, Kajiyama Yusuke, Sato Koichiro, Kikuchi Kentaro, Takahashi Mikiko, Kawamoto Masashi, Yasuda Ichiro
Department of Gastroenterology, Teikyo University Mizonoguchi Hospital.
Fourth Department of Internal Medicine, Teikyo University Mizonoguchi Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2017;114(7):1285-1292. doi: 10.11405/nisshoshi.114.1285.
A 78-year-old man was referred to our hospital with suspected liver abscess. Fever and inflammatory reaction resolved after percutaneous drainage and administration of antibiotics. However, leukocyte count was remarkably increased, and hypercalcemia was noted. The liver mass was also enlarged, as observed in the follow-up abdominal CT scans. Therefore, a percutaneous needle biopsy was performed, and the histopathological findings indicated the presence of adenocarcinoma. Additional blood examination revealed high serum levels of granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP). Lastly, the patient was diagnosed with cholangiocarcinoma producing G-CSF and PTHrP. Chemoradiotherapy with S-1 was initiated, which was partially effective. However, the patient died 134 days after initiating the therapy. Only two cases of cholangiocarcinoma producing G-CSF and PTHrP have been reported to date. Here we reported an additional case of cholangiocarcinoma producing G-CSF and PTHrP.
一名78岁男性因疑似肝脓肿被转诊至我院。经皮引流并使用抗生素后，发热和炎症反应消退。然而，白细胞计数显著升高，并发现高钙血症。在后续的腹部CT扫描中，肝脏肿块也增大了。因此，进行了经皮穿刺活检，组织病理学检查结果显示存在腺癌。进一步的血液检查显示血清粒细胞集落刺激因子（G-CSF）和甲状旁腺激素相关蛋白（PTHrP）水平升高。最后，该患者被诊断为产生G-CSF和PTHrP的胆管癌。开始使用S-1进行放化疗，部分有效。然而，患者在开始治疗134天后死亡。迄今为止，仅报道过两例产生G-CSF和PTHrP的胆管癌病例。在此，我们报告了另外一例产生G-CSF和PTHrP的胆管癌病例。
