Journal of the Formosan Medical Association
Volume 105, Issue 5 , Pages 414-417, 2006

Renal Cell Carcinoma Producing Granulocyte Colony-stimulating Factor

  • Yen-Chieh Wang
    • ,
  • Stone Yang

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr. Stone Yang, Department of Urology, Mackay Memorial Hospital, 92, Section 2, Chung-Shan North Road, Taipei 104, Taiwan
  • Chin-Yuan Tzen

      Affiliations

    • Department of Pathology, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Chun-Chun Lin

      Affiliations

    • Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Johnson Lin

      Affiliations

    • Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

Department of Urolog, Mackay Memorial Hospital, Taipei, Taiwan

Received 29 April 2005; received in revised form 10 June 2005; accepted 2 August 2005.

Article Outline

Severe neutrophilia caused by renal cell carcinoma secreting granulocyte colony-stimulating factor (G-CSF) is a rare manifestation of renal cancer. A 70-year-old woman presented with a 2-year history of severe anemia, severe neutrophilia and elevated serum G-CSF, which completely resolved after radical nephrectomy. Histologic study revealed a histologically high-grade, stage pT1N0M0 renal cell carcinoma. Serum G-CSF level was elevated preoperatively and returned to normal postoperatively. Immunohistochemical study of the tumor tissue using anti-G-CSF monoclonal antibody revealed positive staining in the cancer cells. Careful follow-up of white blood cell count and physical examination for neck lymph node enlargement led to the timely identification of tumor recurrence 17 months after surgery, which resulted in prompt and successful salvage immunotherapy. In this case, G-CSF appeared to contribute to the leukocytosis, as both serum G-CSF level and white blood cell count closely correlated with the clinical tumor growth. White blood cell count should be closely monitored as an indicator of disease activity in patients with G-CSF-producing renal cell carcinoma.

Key Words:  granulocyte colony-stimulating factor , immunohistochemistry , immunotherapy , leukemoid reaction , renal cell carcinoma

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PII: S0929-6646(09)60138-8

doi:10.1016/S0929-6646(09)60138-8

Journal of the Formosan Medical Association
Volume 105, Issue 5 , Pages 414-417, 2006

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