A case of rapidly progressive malignant pleural mesothelioma suspected of producing a granulocyte-colony stimulating factor
Akane Katoa,* Yasuhiro Tanakab Kei Soneharaa Yoshimichi Komatsua Yasuhiro Sakaic Toshitsugu Nakamurad Tsutomu Hachiyaa
aDepartment of Respiratory Medicine, Suwa Red Cross Hospital
bDepartment of Clinical Training Center, Suwa Red Cross Hospital
cDepartment of Molecular Pathology, Shinshu University Graduate School of Medicine
dDepartment of Pathology, Suwa Red Cross Hospital
*Present address: The 1st Department of Internal Medicine, Shinshu University School of Medicine
A 60-year-old male was transported to our hospital by ambulance because of dyspnea. On admission, he exhibited left pleural effusion and multiple masses in the left thoracic wall and was subsequently diagnosed with malignant pleural mesothelioma. Enhanced chest computed tomographic scans showed rapid growth of the masses within a single week. One cycle of chemotherapy with carboplatin and pemetrexed was administered; however, the masses continued to increase in size, and the patient died 39 days after admission. During the administration of chemotherapy, 75 μg of G-CSF was administered from the 8th to 11th days of treatment after the development of grade 2 neutropenia, and the patient's white blood cell count persistently increased to 47,900/μl before his death. Upon pathological dissection, the malignant mesothelioma lesion was suspected to be a G-CSF-producing tumor. Cells from this kind of tumor are thought to have receptors for G-CSF, allowing the lesions to grow independently. Therefore the G-CSF tumor possibly caused the rapid tumor growth observed in this case.
Malignant pleural mesothelioma Granulocyte-colony stimulating factor (G-CSF)
Received 13 Mar 2014 / Accepted 27 Jun 2014
AJRS, 3(5): 700-703, 2014