G-CSF産生耳下腺粘表皮癌の1例

A case of granulocyte colony-stimulating factor-producing mucoepidermoid carcinoma of the parotid gland

I．はじめに

　Granulocyte colony-stimulating factor（以下，G-CSF）は，好中球系造血にほぼ特異的に作用する造血因子で，好中球前駆細胞の増殖と分化を促し，好中球を増加させる作用を有する^1,2）。G-CSF産生腫瘍は肺，膀胱，卵巣などでの報告は多くみられるが，頭頸部領域での報告は少ない。今回われわれは，G-CSF産生耳下腺粘表皮癌の1例を経験したので，文献的考察を加えて報告する。

We report a rare case of granulocyte colony-stimulating factor（G-CSF）-producing mucoepidermoid carcinoma of the parotid gland. A 73-year-old woman presented with a gradually increasing ulcerative mass in the left subaural region. She also manifested complete facial nerve palsy of the affected side. CT and MRI revealed an 80×66 mm ill-defined parotid tumor extending to the parapharyngeal space. Blood examination showed marked neutrophilia（white blood count 23,060/μl,neutrophil 81.5％）. The histological diagnosis of a biopsy specimen was mucoepidermoid carcinoma. Immunohistochemically,the tumor cells expressed G-CSF in their cytoplasm. Although a temporary remission was obtained after neoadjuvant chemotherapy using cisplatin and 5-fluorouracil,the patient died of carcinomatous pleuritis 11 weeks after admission. Reported cases of G-CSF-producing carcinoma of the head and neck were reviewed,and possible pathophysiology of the tumor was bibliographically discussed.