Esophageal carcinosarcoma with granulocyte colony-stimulating factor: a case report

Esophageal carcinosarcoma that disappeared pathologically by palliative radiotherapy alone

Only a few cases of esophageal granulocyte-colony-stimulating-factor (G-CSF)-producing esophageal carcinosarcoma are reported, and patients with G-CSF-producing tumors are typically considered to have poor prognosis. An 89-year-old man was examined for low-grade fever and dysphagia. Chest computed tomography revealed a huge 80-mm tumor on the thoracic esophagus without direct invasion to surrounding organs. Esophagogastroduodenoscopy (EGD) showed a huge mass occupying the esophageal lumen with a superficial flat lesion. Histopathological examination revealed that the tumor was composed of bizarre giant cells and pleomorphic spindle cells with hyperchromatic nuclei. Laboratory data showed aberrant elevation of leukocyte and neutrophil counts and G-CSF levels. The tumor was finally diagnosed as a G-CSF-producing esophageal carcinosarcoma, stage II (T2N0M0, Union for International Cancer Control-TNM Classification of Malignant Tumors, 8th edition). Considering his general condition, we performed palliative radiotherapy (45 Gy/15 fr) alone after consultation with surgeons and radiation oncologists. Follow-up EGD demonstrated the disappearance of the tumor, and the histological assessment of biopsy specimens confirmed no evidence of malignancy. The leukocyte count and G-CSF levels decreased within normal range. This is a very rare case of G-CSF-producing esophageal carcinosarcoma in which a pathologically complete response was achieved using palliative radiotherapy alone.

Severe neutrophilic leukocytosis as a progression marker in granulocyte colony-stimulating factor-producing squamous cell carcinoma of the esophagus

There are very few reports of esophageal carcinoma producing granulocyte colony-stimulating factor (G-CSF). G-CSF-producing esophageal squamous cell carcinoma is an extremely aggressive carcinoma. Leukocyte counts, neutrophil counts, and serum C-reactive protein levels may be markers of its progression.

Granulocyte-colony stimulating factor (G-CSF)-producing esophageal squamous cell carcinoma: a case report

There are very few reports of esophageal G-CSF-producing cancer. This report describes a case of G-CSF-producing esophageal squamous cell carcinoma we recently encountered. A 70-year-old male patient had Stage III esophageal squamous cell carcinoma. The patient received preoperative chemotherapy, and therapeutic response for the primary lesion was rated as complete response and that of the lymph node metastasis as stable disease. A radical operation was then performed. A relapse to neutrophilia occurred as liver metastasis recurred postoperation, and serum G-CSF level was high. Immunohistochemical staining of the resected specimen with anti-G-CSF antibody was positive. The patient died about 1 year after the operation. According to our search of the literature, there are 22 cases of esophageal G-CSF-producing cancer. Carcinosarcoma was more frequent as compared to esophageal non-G-CSF-producing cancer. The prognosis was graver in those cases of G-CSF-producing squamous cell carcinoma, relative to cases of non-G-CSF-producing esophageal squamous cell carcinoma.

Multidisciplinary therapy for granulocyte-colony-stimulating factor producing carcinosarcoma of the esophagus: report of a case

The granulocyte-colony-stimulating factor (G-CSF)-producing esophageal carcinosarcoma is extremely rare in esophageal cancer. In the present case, multidisciplinary therapy, which is surgical resection with preoperative chemotherapy, has been effectively treatment to granulocyte-colony-stimulating factor producing esophageal carcinosarcoma of the esophagus.