G-CSF産生下咽頭癌の1例

A case of G-CSF-producing hypopharyngeal carcinoma

はじめに

　担癌患者において，白血球増多を示すものの明らかな感染源がなく，高granulocyte colony-stimulating factor（G-CSF）血症を示すことがあり，G-CSF産生腫瘍として肺癌を中心に報告されている。頭頸部領域においては，甲状腺癌や鼻副鼻腔癌に多く予後不良の腫瘍として知られているが，下咽頭癌における報告は少ない。今回われわれはG-CSF産生下咽頭癌の1例を経験したので，文献的考察を加えて報告する。

　We presented a rare case of granulocyte colony-stimulating factor（G-CSF）-producing hypopharyngeal carcinoma. A 58-year-old male presented with a dyspnea that rapidly appeared within a month. On examination, he had a solid tumor in the left hypopharynx and multiple lymph node swellings in the left neck. The histopathological examination revealed a moderately differentiated squamous cell carcinoma. During treatment with chemoradiotherapy, leukocytosis was occurred without any infection. We detected a high G-CSF activity in the plasma from the patient. Furthermore immunohistochemical staining showed the tumor expressed G-CSF. Therefore we diagnosed this case with G-CSF-producing hypopharyngeal carcinoma.