顆粒球コロニー刺激因子（G-CSF）産生膀胱癌

A Case of G-CSF Producting Bladder Carcinoma

　82歳，女性。頻尿，排尿時痛を主訴に来院した。膀胱前壁から頂部にかけて5cm大の腫瘍のため，膀胱全摘除術，無カテーテル法による両側尿管皮膚瘻造設術を施行した。術前の末梢血白血球数は20,200／mm³，血清G-CSF濃度は185pg／mlと上昇していたが，膀胱全摘除術後一時正常化した。しかし，術後3か月目に骨盤内に再発し，腫瘍の摘除を行ったが完全除去は不可能であった。患者は初診時より8か月で癌による悪液質にて死亡した。本症例は本邦20例目のG-CSF産生膀胱癌と思われた。

A 82-year-old female was admitted with urinary frequency and dysuria. Cystoscopy and MRI demonstrated a large bladder mass. The laboratory examinations revealed leu-kocytosis of 20,200 /mm³ and elevation of serum G-CSF (185 pg/ml) in the peripheral blood. Total cystectomy and bilateral cutaneous ureterostomy was performed. Histologi-cal diagnosis of the tumor was undifferentiated carcinoma and tumor cells were positive for G-CSF immunohis-tochemical staining. In spite of active treatment, she died of cahexia in 8 months after admission. This was the 20th case in Japanese literature.