[INVASIVE BLADDER CANCER PRODUCING GRANULOCYTE-COLONY STIMULATING FACTOR: A CASE REPORT].

A 72-year-old man presented with the chief complaint of asymptomatic macroscopic hematuria. Cystoscopy revealed a non-papillary sessile tumor in the left bladder wall. Computed tomography revealed a large invasive tumor in the bladder and left hydronephrosis; no metastases were observed. Laboratory examination showed leukocytosis (27,600 /μl) and a high serum level of granulocyte-colony stimulating factor (G-CSF; 158 pg/ml). A diagnosis of locally advanced bladder cancer producing G-CSF was made; therefore, the patient underwent a total cystectomy and urinary diversion with an ileal conduit. Histopathological examination of the surgical specimen revealed a urothelial carcinoma with squamous differentiation (pT3a, pN0, ly1, v1). In terms of their immunohistochemistry, the tumor cells were shown to express G-CSF. After surgery, the leukocyte count and serum level of G-CSF decreased to normal values. No recurrence was observed in the 41 months after surgery without adjuvant therapy. We reviewed 73 cases of bladder cancer producing G-CSF reported in the literature in Japan.