Granulocyte-colony stimulating factor-producing pancreatic adenosquamous carcinoma showing aggressive clinical course

Intern Med. 2009;48(9):687-91. doi: 10.2169/internalmedicine.48.1900. Epub 2009 May 1.


Herein, we encountered an 89-year-old woman with pancreatic cancer who presented with fever without infective focus, leukocytosis of 45,860 /microL, and elevation of serum granulocyte-colony stimulating factor (G-CSF). The patient could not receive any curative therapy due to an extremely aggressive clinical course. Specimens taken at necropsy revealed an adenosquamous carcinoma positive for G-CSF by immunohistochemistry; it was only the second reported case to date. She was finally diagnosed with G-CSF-producing pancreatic cancer. In light of the above, clinicians should consider the presence of G-CSF-producing tumors, including pancreatic cancer, when presented with patients showing leukocytosis of unknown origin and fever without infective focus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Carcinoma, Adenosquamous / diagnosis*
  • Carcinoma, Adenosquamous / immunology
  • Carcinoma, Adenosquamous / metabolism
  • Female
  • Granulocyte Colony-Stimulating Factor / biosynthesis*
  • Humans
  • Leukocytosis / diagnosis
  • Leukocytosis / immunology
  • Lung Neoplasms / immunology
  • Lung Neoplasms / secondary
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / immunology
  • Pancreatic Neoplasms / metabolism


  • Granulocyte Colony-Stimulating Factor