Aggressive carcinosarcoma of the uterine cervix associated with high levels of granulocyte colony stimulating factor: Case report and laboratory correlates

Background.Production of granulocyte colony stimulating factor (G-CSF) by solid tumors, including cervix cancers, is reported to be associated with an aggressive clinical course.Case.A 64-year-old female with a locally advanced carcinosarcoma of the cervix presents with a WBC count of 48,000 cells/μl with no infectious causes. Her WBCs returned to normal during primary radiotherapy and then increased again with recurrence. She expired of progressive disease 10 weeks after primary therapy. Serum and pleural fluid levels of G-CSF were 1500 and 6000 pg/ml, respectively. Cancer cells secreted G-CSF in culture and recombinant G-CSF increased cancer cell proliferation.Conclusions.Like other sarcomas, carcinosarcomas can produce high levels of G-CSF and demonstrate an aggressive behavior that may be autocrine stimulation.