Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review

Kaneko, Naoki; Matsubara, Ryota; Goto, Yuichi; Jinno, Teppei; Maruse, Yasuyuki; Sakamoto, Toshihiro; Hashiguchi, Yasuyuki; Iida, Masakazu; Nakamura, Seiji

doi:10.1186/s12957-016-0918-1

Cited by 13 publications

(15 citation statements)

References 28 publications

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“…The survival time of patients with G-CSF-producing tumors has been reported to be approximately 6 months (5). To our knowledge, 7 of 8 patients with these tumors in the head and neck region died within 1 year of diagnosis (average 8 months), as did our patient (4,7,(12)(13)(14)(15)(16)(17).…”

Section: Discussionsupporting

confidence: 53%

“…The lungs are the most frequent site of G-CSF producing tumors (2), followed by sites such as the liver (11), stomach (5) and bladder (1). However, G-CSF producing tumors are rarely detected in the oral regions (4,7,12,13). The survival time of patients with G-CSF-producing tumors has been reported to be approximately 6 months (5).…”

Section: Discussionmentioning

confidence: 99%

“…G-CSF is frequently produced by poorly differentiated and undifferentiated carcinomas (5,6), and many of these G-CSF producing tumors are initially detected at advanced stage (1,(5)(6)(7)12,13). In addition, the G-CSF produced by these tumors may contribute to tumor progression by autocrine and paracrine mechanisms (18,19), as well as promoting angiogenesis and tumor growth (20).…”

Section: Discussionmentioning

confidence: 99%

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G‑CSF producing oral carcinoma with diffuse uptake of FDG in the bone marrow: A case report

et al. 2017

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Abstract.A 78-year-old male patient was referred to the Department of Oral Surgery, Hokuto Hospital (Obihiro, Japan) for painless swelling on the left neck and tongue. Histopathological examination of a biopsy specimen resulted in a diagnosis of squamous cell carcinoma of the tongue. Imaging examinations revealed cervical lymph node metastases on both sides, along with diffuse uptake of 18 F-fluorodeoxyglucose (FDG) in the bone marrow of the spine and pelvis. Hematologic tests revealed an increased white blood cell (WBC) count and serum concentrations of granulocyte colony stimulating factor (G-CSF). These findings suggested a G-CSF producing tumor, with fluctuations of WBC count, serum G-CSF concentration, and FDG uptake in the bone marrow, associated with tumor shrinkage and enlargement, an indicator of tumor status. IntroductionGranulocyte colony stimulating factor (G-CSF) is a cytokine mainly produced by macrophages, fibroblasts and endothelial cells in an inflammatory milieu. G-CSF stimulates neutrophil precursors, resulting in an increase in neutrophils, and recruits neutrophils from the bone marrow to peripheral blood. G-CSF is an important factor in infection prophylaxis, and recombinant G-CSF is universally used to treat neutropenia (1). G-CSF is also produced by non-hematologic malignancies with high leukocyte counts, consisting predominantly of neutrophils, in patients without infectious diseases. Most of these G-CSF producing tumors are present in the lungs (2), with tumors in the oral regions being rare. This report describes a patient with a tongue carcinoma producing G-CSF, as well as showing diffuse uptake of FDG in the bone marrow. Case reportIn July 2013, a 78-year-old man visited the Department of Oral Surgery, Hokuto Hospital (Obihiro, Japan) with a 2-week history of painless swelling on the left neck and tongue. The patient had no systemic complications and no significant family history. Some cervical lymph nodes on both sides were palpable (Fig. 1A). Intra-oral examination showed a tumor with induration about 40 mm in diameter on the left side of the tongue (Fig. 1B). Cytological examination of a swollen left lymph node showed atypical squamous cells, and pathological examination of a biopsy of the tongue tumor revealed a squamous cell carcinoma. A computed tomography (CT) scan with contrast demonstrated a large lateral oral tongue tumor of diameter 42 mm, without extension to the extrinsic muscles of the tongue; and some metastatic cervical lymph nodes that were enlarged, nonhomogeneously enhanced, and partially necrotic. Metastatic disease of left middle jugular lymph node was >30 mm in maximum diameter (Fig. 2). 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT showed abnormally high uptake by the tongue tumor (maximum standardized uptake value [SUVmax] 22.19) and by the four large metastatic nodes, with the large left middle jugular node having an SUVmax of 14.43 (Fig. 3A). Diffuse FDG uptake was also observed in the bone marrow of the spine and pelvis (Fig. 3B). These f...

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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G‑CSF producing oral carcinoma with diffuse uptake of FDG in the bone marrow: A case report

et al. 2017

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“…The first PLR due to CST was reported in 1977 in a patient with lung cancer 5. Since then, it has been reported in patients with melanoma, mesothelioma, carcinomas and sarcomas of various origins (biliary tree, oesophagus, gallbladder, head and neck, liver, stomach, urinary bladder and thyroid) 1 4 6–17…”

Section: Introductionmentioning

confidence: 99%

“…In patients with PLR, G-CSF is directly secreted by tumour cells into the host’s circulation, leading to cytokine-mediated granulocytosis 20. Some tumours can simultaneously secrete parathyroid hormone-related protein in addition to CSF, leading to combined hypercalcaemia and leukocytosis of the host 16…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic leukemoid reactions induced by cytokine-secreting tumours

2020

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Paraneoplastic leukemoid reaction (PLR) is the extreme leukocytosis that occurs due to a non-haematolymphoid cytokine-secreting tumour (CST) in the absence of bone marrow infiltration by that solid tumour. The clinical presentation is widely variable, and therefore challenging. If the underlying malignancy is not clinically apparent, PLR could be mistaken for myeloproliferative neoplasms, altering the patient’s management. CSTs are highly aggressive tumours associated with a poor prognosis due to multiple mechanisms. Localising and treating the underlying malignancy is the mainstay of treatment. Both the treating clinician and the pathologist should keep a high level of suspicion for this entity in patients having unexplained leukocytosis. We herein discuss the underlying mechanisms, clinical presentation, pathological features, differential diagnosis and prognosis of this rare entity. An emphasis on the role of the pathologist is provided since the lack of knowledge on this entity can lead to dramatic effects on the patient, including unnecessary diagnostic testing and treatments.

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Squamous cell carcinoma of mandibular gingiva producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report

Kaibuchi,

Akagi,

Kagawa

et al. 2024

Oral Maxillofac Surg

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Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review

Cited by 13 publications

References 28 publications

G‑CSF producing oral carcinoma with diffuse uptake of FDG in the bone marrow: A case report

G‑CSF producing oral carcinoma with diffuse uptake of FDG in the bone marrow: A case report

Paraneoplastic leukemoid reactions induced by cytokine-secreting tumours

Squamous cell carcinoma of mandibular gingiva producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report

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