[A G-CSF-Producing Adenosquamous Carcinoma of the Gallbladder with Early Postoperative Recurrence and Rapid Growth-A Case Report]

Abstract

A 66-year-old woman was referred to our hospital with a chief complaint of a persistent high fever lasting for 3 weeks. She exhibited a high inflammatory response, and an abdominal CT scan revealed a 60 mm mass in the body of the gallbladder. Unable to differentiate between infection and neoplasm, we decided to proceed with surgery. We performed cholecystectomy and distal gastrectomy, because of the gallbladder tumor invasion to the gastric antrum. Pathological examination diagnosed the tumor as adenosquamous carcinoma of the gallbladder with positive lymph node metastasis. Preoperative specimens showed elevated levels of granulocyte-colony stimulating factor(G-CSF), indicating that the tumor was producing G-CSF. Postoperatively, the patient's inflammation improved rapidly. However, at 6 weeks post-surgery, she presented with fever and increased inflammation, and a 40 mm mass was detected at the duodenal stump, leading to a diagnosis of recurrence. Chemotherapy was initiated but proved ineffective, and the patient succumbed 24 weeks after surgery. This report discusses a case of G-CSF-producing adenosquamous carcinoma of the gallbladder, which demonstrated early postoperative recurrence, rapid growth and poor prognosis.