Two cases of
bladder tumor producing
granulocyte colony-stimulating factor (
G-CSF) are reported. The first case was in a 79-year-old female patient. A large
bladder tumor was diagnosed as right-sided
hydronephrosis. The
tumor consisted mostly of
squamous cell carcinoma with a few transitional cells. Total
cystectomy could not be performed because of direct invasion by the
tumor into the pelvis. The patient died without aggressive treatment about 7 months after admission. Her leukocyte count consistently increased up to 76,200/mm3. The serum
G-CSF levels were not analyzed. However, immunohistochemical examination revealed a high concentration of
G-CSF in the
tumor specimen. The other case was in an 80-year-old male patient. The patient, who had refused total
cystectomy for
bladder tumor (
transitional cell carcinoma, grade 2, T2N0M0) 2 years earlier, underwent ureterocutaneostomy for obstructive
renal insufficiency. Total
cystectomy was not performed at this admission because of
tumor invasion into the rectum and his advanced age.
Radiotherapy was administered. However, he developed
ileus caused by direct
tumor invasion into the ileum. He died about 10 months after the
urinary diversion.
Leukocytosis, which improved transiently following
radiotherapy, became more severe. The maximum leukocyte count was 49,500/mm3 just before death. The serum
G-CSF levels during and after
radiotherapy were 54 pg/ml and < 30 pg/ml, respectively. Immunohistochemical examination revealed the presence of
G-CSF in the
tumor. These findings suggest the production of
G-CSF by the
bladder tumor.