A 73-year-old man was admitted to the hospital complaining of gross hematuria and left flank pain. Abdominal ultrasonography and computed tomography revealed a left renal tumor with extracapsular extension. Laboratory data showed marked leukocytosis of 121,000/mm3 and hypercalcemia of 12.3 mg/dl without any findings of inflammatory disease or bone metastasis. Enzyme immunoassay of the serum demonstrated a high level of granulocyte colony-stimulating factor (250 pg/ml) and parathyroid hormone-related protein (1,069 pmol/l). Pathological diagnosis of needle biopsy specimen of the primary tumor was transitional cell carcinoma which was suspected to have originated from renal pelvis. Immunohistochemical examination with anti-granulocyte colony-stimulating factor monoclonal antibody demonstrated granulocyte colony-stimulating factor production in cancer cells. The patient underwent a course of systemic chemotherapy, but died two months after diagnosis. To our knowledge, this is the first report of renal pelvic cancer representing granulocyte colony-stimulating factor production and hypercalcemia simultaneously.
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