An Elderly Lung Cancer Patient Producing CSF whose Symptoms Markedly Improved after Resection

An 83-year-old female was admitted with high fever and shaking chills. A roentgenogram showed a mass shadow in the right upper lobe. Fever up to 39.5°C, increased CRP of 11.5mg/dl, and marked leucocytosis up to 38, 100 with neutrophilia seemed to be due to empyema. In spite of intensive care with antibiotics, the tumor increased and the patient's condition deteriorated. Right upper lobectomy was performed. CSF (colony stimulating factor) was detected in the tumor. The histological type was poorly differentiated squamous cell carcinoma with giant cell carcinoma, and the surgical margin was negative. Soon after surgery, almost all symptoms disappeared, and the data such as inflammatory reactions, hyponatremia and impaired glucose tolerance ability improved. Even in elderly patients, giant cell carcinoma should be resected if the tumor seems to be the main cause of the impaired condition of the patient.