Granulocyte-colony stimulating factor (G-CSF) producing malignant pleural mesothelioma: Report of a case

Our plain-English summary of Granulocyte-colony stimulating factor (G-CSF) producing malignant pleural mesothelioma: Report of a case, by A. Fujiwara, M. Higashiyama, T. Kanou, et al (Thoracic Cancer, 2015).

The study

• Authors: A. Fujiwara, M. Higashiyama, T. Kanou, J. Okami, T. Tokunaga, Y. Tomita, K. Kodama
• Journal: Thoracic Cancer
• Published: 2015;6(1):105-9
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

This report presents a case of malignant pleural mesothelioma (MPM) producing granulocyte colony-stimulating factor (G-CSF) that was treated by tumor resection. A 76-year-old male presented with a huge right-side chest wall tumor, along with a slight fever and chest wall pain. Laboratory findings showed an increased white blood cell count (64600 cells/μL) and C-reactive protein level (20.57 mg/dL). The patient underwent surgical removal of the tumor along with tissue from the chest wall and histopathological analysis led to a diagnosis of sarcomatous type of MPM. Immunohistochemical findings for both anti-human G-CSF and interleukin-6 monoclonal antibodies were positive. Although the general condition of the patient quickly improved after surgery, local recurrence occurred two months later and he died of respiratory failure seven months after the operation, though surgery provided symptom relief. G-CSF-producing MPMs usually show a poor prognosis, though less-invasive surgery may be considered for relief of symptoms.

In plain English

This case report described a 76-year-old man, treated in Osaka, Japan, whose malignant pleural mesothelioma produced granulocyte colony-stimulating factor (G-CSF). He had smoked for 55 years and worked 60 years as an auto mechanic, which the authors said suggested possible asbestos exposure. No fiber type was reported. He had an 11 cm right chest wall tumor, slight fever and chest wall pain. His white blood cell count was 64600 cells/μL and serum G-CSF 71.8 pg/mL (normal range 5.8 to 27.5). Surgeons removed the tumor with part of the chest wall and lung. It was diagnosed as sarcomatous mesothelioma, staining positive for G-CSF and interleukin-6. After surgery his white blood cell count and C-reactive protein returned to normal, G-CSF fell to 8.22 pg/mL, and pain resolved. The tumor recurred in the pleural cavity two months later. He then had radiotherapy, plus chemotherapy stopped after two courses because the tumor progressed. He died of respiratory failure seven months after the operation. The authors concluded that less-invasive surgery may be considered to prolong survival and maintain quality of life, depending on prognosis.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient), with a table comparing six previously published cases
• Who was studied: One previously healthy 76-year-old male with a 55-year smoking history, treated at the authors' center (Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan); dates of treatment not stated
• Exposure: Worked as an auto mechanic for 60 years, which the authors said suggested the possibility of asbestos exposure; no fiber type or dose reported
• Main results:
  • The patient's white blood cell count was 64600 cells/μL (94.6% neutrophils) and C-reactive protein was 20.57 mg/dL
  • The patient's serum G-CSF was 71.8 pg/mL (normal range 5.8 to 27.5) and interleukin-6 was 40.5 pg/mL (normal less than 4.0)
  • The chest wall tumor measured 11 cm, had destroyed the fourth and fifth ribs, and had invaded the lung
  • The resected tumor was diagnosed as sarcomatous type malignant pleural mesothelioma
  • Immunostaining of the resected tumor for G-CSF and interleukin-6 was positive
  • After surgery, the white blood cell count and C-reactive protein decreased to normal levels, serum G-CSF fell to 8.22 pg/mL, and chest wall pain resolved
  • Two months after surgery the tumor recurred locally in the pleural cavity without distant spread, and serum G-CSF rose again to 69.0 pg/mL
  • The patient received radiotherapy at 60 Gy; chemotherapy with cisplatin and pemetrexed was stopped after two courses because of tumor progression
  • Seven months after surgery the patient was admitted for coughing up blood and died of respiratory failure
• The authors' conclusion: The authors concluded that the early recurrence and death showed how malignant such tumors are. They wrote that less-invasive surgery may be considered to both prolong survival and maintain quality of life, depending on prognosis.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Monoclonal Antibody, Prognosis.

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