Hypopharyngeal squamous cell carcinoma producing both granulocyte colony-stimulating factor and parathyroid hormone-related protein

Pathol Int. 2008 Oct;58(10):652-6. doi: 10.1111/j.1440-1827.2008.02285.x.

Abstract

A 57-year-old woman was admitted to Hokkaido University Hospital because of dysphagia. Laryngoscopy indicated hypopharyngeal tumor histologically diagnosed as squamous cell carcinoma (SCC). A combination of radiotherapy and chemotherapy was performed for 2 months, and the hypopharyngeal lesion completely regressed. After 4 months, fever, anorexia, and malaise appeared, and chest X-ray and CT indicated two large tumors in the right lung. Transbroncheal lung biopsy (TBLB) specimens were diagnosed as SCC. Laboratory data showed high levels of serum granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP). Subsequently, positron emission tomography (PET) showed multiple metastases to several organs including the liver, spine, skull, and thigh. Two months after readmission, the patient died with no success of chemotherapy. At autopsy, the lung tumor was clearly positive for both G-CSF and PTHrP on immunohistostaining. Retrospectively, examination showed that the primary pharyngeal tumor was focally positive for these two cytokines. Thus, a certain population of hypopharyngeal cancer producing G-CSF and PTHrP, spread to various organs and contributed to the rapid progression and poor prognosis. This case is presented with a discussion of several other cases in the literature.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Squamous Cell / metabolism*
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / therapy
  • Combined Modality Therapy
  • Deglutition Disorders / pathology
  • Fatal Outcome
  • Female
  • Granulocyte Colony-Stimulating Factor / blood*
  • Humans
  • Hypopharyngeal Neoplasms / metabolism*
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / therapy
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / secondary
  • Middle Aged
  • Parathyroid Hormone-Related Protein / blood*

Substances

  • Parathyroid Hormone-Related Protein
  • Granulocyte Colony-Stimulating Factor