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A case of granulocyte colony‐stimulating factor and interleukin 6 receptor‐producing mediastinal mature cystic teratoma with somatic‐type malignancy
Author(s) -
Masunaga Atsuko,
Sato Yuichi,
Kadofuku Tsuyoki,
Iwamoto Sanju,
Masuda Mikio,
Suzuki Shuichi,
Suzuki Takashi,
Miyazaki Akira,
Mitsuya Toshiyuki
Publication year - 2011
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2010.02641.x
Subject(s) - malignancy , pathology , medicine , leukocytosis , adenocarcinoma , immunohistochemistry , cancer
Mediastinal germ cell tumor with somatic‐type malignancy is a rare neoplasm. We describe one such case in a 49‐year‐old Japanese man who had shown an elevated serum concentration of granulocyte colony‐stimulating factor (GCSF) and leukocytosis without a shift to the left. Histologically, the tumor formed a teratomatous cyst whose wall contained benign epithelial components, well‐differentiated tubular and mucinous adenocarcinoma, and poorly‐differentiated pleomorphic carcinoma. Immunohistochemically, both the well differentiated adenocarcinoma and poorly differentiated pleomorphic carcinoma expressed GCSF. Immunohistochemistry and molecular analysis revealed that both components also produced interleukin 6 receptor (IL6R). We diagnosed this tumor as a GCSF‐ and IL6R‐producing mediastinal mature cystic teratoma with somatic‐type malignancy. The tumor showed immunohistochemical expression of activated signal transducer and activator of transcription 3. The patient died 6 months after developing systemic symptoms. For a GCSF‐producing tumor, complete resection appears to offer the best outcome at present. For any patient presenting with leukocytosis without a shift to the left, a thorough analysis should be conducted, and the tumor diagnosed as early as possible.