Complete spontaneous remission in a patient with metastatic non-small-cell lung cancer

Abstract

SummarySpontaneous remission of cancer (SR) is defined as a complete or partial, temporary or permanent disappearance of all or at least some relevant parameters of a soundly diagnosed malignant disease without any medical treatment or with treatment that is considered inadequate to produce the resulting regression. We report the case of a 61-year-old man who presented with extensive metatastic disease five months after pneumonectomy for poorly differentiated large cell and polymorphic lung cancer. A vast metastatic tumour mass of the abdominal wall was confirmed histolologically and there was clinical and radiographic evidence of liver and lung metastases. Eight months later, the patient was operated on for a hernia, which had developed in the inguinal biopsy scar and the surgeon confirmed complete clinical SR of the abdominal wall metastases. Again five months later there was no longer any radiologic evidence of liver and lung metastases. Complete remission has persisted more than five years. Histology of the primary and of the abdominal metastases were reviewed by several independent pathologists. SR is an extremly rare event in lung cancer. This is the first documented case of clinically evident visceral metastases of a bronchiogenic adenocarcinoma developing after complete resection of the primary and then showing complete SR. The epidemiology of SR is reviewed and possible mechanisms involved in SR are discussed.

Spontaneous Regression of Hodgkin Lymphoma: Case Report and Review of the Literature

“…Immune dysregulation has been shown to play an important role in the pathogenesis of several lymphoma subtypes, such as patients with human immunodeficiency virus-related lymphoma or post-transplant lymphoproliferative disorders. In HL, this might be implied by the increased risk amongst patients with inflammatory diseases, such as rheumatoid arthritis, systemic lupus erythematosus and sarcoidosis [16]. Furthermore, programmed death-1 pathway inhibitors, which have an immunomodulatory effect, are effective against certain malignancies, including HL [15].…”

“…Hormonal changes have been implicated in some cases of SR of some malignancies during pregnancy or after childbirth. Other possible mechanisms include differentiation mechanisms or telomerase inhibition [16]. …”

Small-cell Lung Cancer Exhibiting Spontaneous Regression

“…There are several possible mechanisms, including apoptosis, immunological and cytokine mechanisms, differentiation mechanisms, hormonal mechanisms, angiogenesis inhibition, telomerase inhibition and psychoimmunological mechanisms induced by causative factors, such as infection, fever, drugs, radiation, trauma, including surgery, hormones, pregnancy and carcinogens (9,11). Several reports have discussed the spontaneous regression of SCLC and paraneoplastic neuropathy (2-5).…”

Spontaneous Remission of Metastases of Cancer of the Uterine Cervix

“…SR of cancer of the uterine cervix is extremely rare, and only 5 cases are published worldwide [5], including that of a woman with metastases unfortunately lacking histological proof [6]. Numerous excellent reviews have been published regarding the causes of SR [7][8][9]. Most research has focused on mechanisms of immunomodulation [10].…”