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[切除产生粒细胞集落刺激因子的胰腺间变性癌,伴恶性肿瘤体液性高钙血症]

[Resection of a Granulocyte Colony-Stimulating Factor-Producing Anaplastic Carcinoma of the Pancreas, Associated with Humoral Hypercalcemia of Malignancy].

作者信息

Seki Hiroaki, Yasui Nobutaka, Shimada Akihiko, Matsumoto Hidetoshi, Domoto Hideharu

机构信息

Dept. of Surgery, Keiyu Hospital.

出版信息

Gan To Kagaku Ryoho. 2018 May;45(5):859-862.

Abstract

We herein report the case of a 65-year-old man who presented with an anaplastic carcinoma of the pancreas, producing granulocyte colony-stimulating factor (G-CSF). The patient's laboratory data showed an increase in his serum CA19-9 levels 1 year after he had undergone surgery for transverse colon cancer. Computed tomography (CT) showed a mass in the pancreatic head. Following a diagnosis of primary or metastatic pancreatic cancer, we performed the pancreatoduodenectomy. The postoperative course was uneventful. However, on postoperative day 28, he suffered a disturbance of consciousness and demonstrated hypercalcemia with elevated serum levels of parathyroid hormone-related protein (PTHrP). CT revealed multiple liver metastases and massive ascites. His serum Ca level decreased temporarily, and he subsequently died 58 days after the pancreatoduodenectomy. A pathological examination revealed pleomorphic-type anaplastic carcinoma of the pancreas. Immunohistochemical staining showed the tumor cells to be positive for G-CSF. To the best of our knowledge, there have been no reports of G-CSF-producing anaplastic carcinoma of the pancreas associated with humoral hypercalcemia of malignancy.

摘要

我们在此报告一例65岁男性,其患有产生粒细胞集落刺激因子(G-CSF)的胰腺间变性癌。该患者的实验室数据显示,在他接受横结肠癌手术后1年,其血清CA19-9水平升高。计算机断层扫描(CT)显示胰头有肿块。在诊断为原发性或转移性胰腺癌后,我们进行了胰十二指肠切除术。术后过程顺利。然而,在术后第28天,他出现意识障碍,并表现出高钙血症,血清甲状旁腺激素相关蛋白(PTHrP)水平升高。CT显示多发肝转移和大量腹水。他的血清钙水平暂时下降,随后在胰十二指肠切除术后58天死亡。病理检查显示为胰腺多形型间变性癌。免疫组织化学染色显示肿瘤细胞G-CSF呈阳性。据我们所知,尚无关于产生G-CSF的胰腺间变性癌伴恶性肿瘤体液性高钙血症的报道。

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