Carcinosarcoma of the liver producing granulocyte-colony stimulating factor

Pathol Int. 2006 Jul;56(7):413-9. doi: 10.1111/j.1440-1827.2006.01979.x.


An autopsy case of carcinosarcoma of the liver producing granulocyte-colony stimulating factor (G-CSF) is reported. The patient, a 74-year-old Japanese man, presented with multiple liver masses. His serum G-CSF was elevated to 286 pg/mL and a marked leukocytosis of 19 100/microL was observed. The patient had a rapidly aggravated clinical course and died 57 days after admission. Autopsy revealed a liver carcinosarcoma composed both of hepatocellular carcinoma (HCC) and sarcomatous elements immunoreactive with alpha-smooth muscle actin and desmin. Immunohistochemistry revealed positive staining of G-CSF in the cytoplasm of HCC, whereas none of the spindle cells was positively stained. Production of G-CSF was also confirmed by enzyme-linked immunosorbent assay, using the frozen tumor tissue taken at the autopsy. Similar to the majority of G-CSF-producing tumors in the literature, only the epithelial elements of the present case were immunopositive for G-CSF. Although a monoclonal origin of carcinosarcomas has generally been proposed, heterologous differentiation from a single clone might lead to the production of G-CSF only in the epithelial element in the present case. It is suggested that G-CSF was associated with the high-grade transformation of the epithelial elements, as well as the reported phenomenon of conventional HCC producing G-CSF.

Publication types

  • Case Reports

MeSH terms

  • Actins / analysis
  • Aged
  • Biomarkers, Tumor / analysis
  • Carcinoma, Hepatocellular / blood*
  • Carcinoma, Hepatocellular / pathology
  • Carcinosarcoma / blood*
  • Carcinosarcoma / pathology
  • Desmin / analysis
  • Enzyme-Linked Immunosorbent Assay
  • Fatal Outcome
  • Granulocyte Colony-Stimulating Factor / blood*
  • Humans
  • Leukocytosis / pathology
  • Liver / diagnostic imaging
  • Liver Neoplasms / blood*
  • Liver Neoplasms / pathology
  • Male
  • Tomography, X-Ray Computed


  • Actins
  • Biomarkers, Tumor
  • Desmin
  • Granulocyte Colony-Stimulating Factor