PMC5436015_01
Serial computerized tomography (CT) images of case 1. a The full-body CT scan shows left pelvic cancer with no lymph node or visceral metastases at diagnosis. b The left pelvic cancer has enlarged in size despite 2 courses of gemcitabine/cisplatin and 1 course of methotrexate/epirubicin/cisplatin.
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Cystoscopy showed no tumor, and a full-body CT scan showed a left renal pelvic tumor with no lymph node metastasis or visceral metastasis (Fig. 1a). After 1 course of MEC, the primary tumor enlarged even further, although there was no obvious metastasis on CT (Fig. 1b).
Pathological examination of the left nephroureterectomy specimen from case 1 in March 2015 shows that it is positive for anti-G-CSF immunostaining. x100.
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A pathological examination of the resected specimen showed invasive UC, pT3bN0M0, pStage III, that was positive for anti-G-CSF immunostaining (Fig. 2).
Clinical course and changes of leukocyte and G-CSF levels.
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The patient has been followed up for 24 months after diagnosis without any evidence of recurrence on CT and with serum G-CSF levels remaining stable within the reference range (Fig. 3).
PMC5436015_02
Serial computerized tomography (CT) images of case 2. a The full-body CT scan shows multiple bladder cancer with no lymph node or visceral metastases at diagnosis. b The bladder cancer has reduced in size after 3 courses of gemcitabine/cisplatin.
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With full-body CT scanning and magnetic resonance imaging, we diagnosed his tumor as urinary bladder cancer, cT3N0M0, cStage III (Fig. 4a). After 3 courses of GC, the tumor size decreased on CT (Fig. 4b) and cystoscopy, while serum G-CSF increased to 185 pg/mL.