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Carcinosarcoma of the gallbladder producing α-fetoprotein and manifesting as leukocytosis with elevated serum granulocyte colony-stimulating factor: Report of a case

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Abstract

A 69-year-old man was referred to our hospital for investigation of leukocytosis and a persistent fever of 38°C, but we could find no evidence of a specific infection. The leukocyte count was 18 000/mm3, and the serum granulocyte colony-stimulating factor (G-CSF) and α-fetoprotein (AFP) levels were both elevated, at 66.3 pg/ml and 1,495 ng/ml, respectively. Computed tomography (CT) showed a gallbladder tumor and we performed extended cholecystectomy. Postoperatively, the fever subsided and the leukocyte count, serum G-CSF and AFP level normalized. Histologically, the tumor was a carcinosarcoma of the gallbladder. Immunohistochemical staining of the tumor cells was positive for AFP, but negative for G-CSF. This is the first report of a carcinosarcoma of the gallbladder producing AFP. The laboratory findings and clinical course strongly suggested that the tumor produced not only AFP, but also G-CSF.

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Authors and Affiliations

  1. Department of Surgery, Osaka General Medical Center, 3-1-56 Mandai-Higashi, Sumiyoshi, Osaka, 558-8558, Japan

    Kazunori Shimada, Kazuhiro Iwase, Toyokazu Aono, Sumio Nakai, Shin-Ichi Takeda, Makoto Fujii, Masaru Koma, Kazuhiro Nishikawa, Chu Matsuda, Masashi Hirota & Yasuhiro Tanaka

  2. Department of Pathology, Osaka General Medical Center, 3-1-56 Mandai-Higashi, Sumiyoshi, Osaka, 558-8558, Japan

    Hiroaki Fushimi

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  1. Kazunori Shimada
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  2. Kazuhiro Iwase
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  3. Toyokazu Aono
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  4. Sumio Nakai
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  5. Shin-Ichi Takeda
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  6. Makoto Fujii
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  8. Kazuhiro Nishikawa
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  9. Chu Matsuda
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  12. Yasuhiro Tanaka
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Shimada, K., Iwase, K., Aono, T. et al. Carcinosarcoma of the gallbladder producing α-fetoprotein and manifesting as leukocytosis with elevated serum granulocyte colony-stimulating factor: Report of a case. Surg Today 39, 241–246 (2009). https://doi.org/10.1007/s00595-008-3833-4

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  • DOI: https://doi.org/10.1007/s00595-008-3833-4

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