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Int Cancer Conf J. 2018 Jun 1;7(3):107-113. doi: 10.1007/s13691-018-0330-5. eCollection 2018 Jul.

Granulocyte-colony-stimulating factor-producing metaplastic carcinoma of the breast with significant elevation of serum interleukin-17 and vascular endothelial growth factor levels.

Author information

1
1Department of Breast Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan.
2
2Department of Diagnostic Pathology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan.
3
3Department of Diagnostic Radiology, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan.
4
4Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507 Japan.
5
Department of Plastic Surgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, 524-8524 Japan.
6
6Department of Medical Oncology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763 Japan.

Abstract

Granulocyte-colony-stimulating factor (G-CSF) production in carcinomas is associated with a very aggressive phenotype. Interleukin (IL)-17 secreted from tumor-infiltrating lymphocytes induces the production of G-CSF and vascular endothelial growth factor (VEGF) in cancer tissue. We present a case of a G-CSF-producing metaplastic breast carcinoma (MpBC) accompanied by systemic elevation of IL-17 and VEGF levels. A 56-year-old woman presented with a rapidly growing tumor measuring > 10 cm in her left breast. Core needle biopsy confirmed the diagnosis as MpBC with triple-negative features. Diffuse fluorodeoxyglucose uptake in the long bones and marked leukocytosis suggested that the G-CSF was produced by the primary tumor, which showed upregulated G-CSF mRNA and protein levels. Multiplex cytokine assessment identified increased serum IL-17, VEGF, and G-CSF levels. After radical mastectomy and skin grafting, the leukocyte count and serum G-CSF, IL-17, and VEGF levels were normalized. She underwent postmastectomy radiotherapy (50 Gy/25 Fr) and adjuvant chemotherapy (90 mg/m2 of epirubicin and 600 mg/m2 of cyclophosphamide followed by 80 mg/m2 of paclitaxel) and is alive without recurrence. This is the first in vivo observation that describes the systemic elevation of IL-17 and VEGF levels with concomitant G-CSF production. Further research is warranted to study the IL-17/G-CSF/VEGF axis as a potential therapeutic target for this aggressive type of breast cancer.

KEYWORDS:

Granulocyte-colony-stimulating factor; Interleukin-17; Metaplastic breast carcinoma; Vascular endothelial growth factor

PMID:
31149526
PMCID:
PMC6498343
[Available on 2019-06-01]
DOI:
10.1007/s13691-018-0330-5

Conflict of interest statement

The authors declare that they have no conflict of interest.The tests presented in this report were performed under the approval of the Ethics Committee of Kyoto University Hospital (Protocol number; G424).Written informed consent for the usage of patient-derived resources was obtained from the patients prior to the research and the publication.

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