Complete spontaneous remission of non-small-cell lung cancer: a case report

doi:10.1016/j.lungcan.2004.01.026

Lung Cancer

Volume 45, Issue 2, August 2004, Pages 263-266

https://doi.org/10.1016/j.lungcan.2004.01.026 Get rights and content

Abstract

Spontaneous remission (SR) of cancer is a rare event, particularly in lung cancer. We report the case of a 68-year-old man, who came to our attention with a diagnosis of poorly differentiated pulmonary adenocarcinoma and, in absence of any active therapy, underwent a durable complete SR.

Our case supports the rare occurrence of SR in non-small-cell lung cancer (NSCLC).

Introduction

Spontaneous remission (SR) of cancer, according to a generally accepted definition, is 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. SR is an extremely rare event. Everson and Cole reported only 176 cases of SR from 1900 to 1964, with an estimated incidence of 1 out of 60,000–100,000 people with cancer [1], [2]. Although SR is seen sporadically in any type of cancer, it has been reported especially in a few types of tumours, where the host immune system is known to play an important role, as malignant melanoma, renal cell cancer, low-grade non-Hodgkins’s lymphoma, chronic lymphocytic leukaemia and neuroblastoma in children. SR is considered to be a particularly rare event in lung cancer [3]. Contemporary with the first observations of SR the interest was raised about the possible biological mechanisms involved in this phenomenon, which unfortunately remains still unexplained.

Section snippets

Discussion

A 68-year-old Caucasian man was admitted to the hospital in October 1999, because of acute respiratory insufficiency without fever or signs of infection. The patient was a heavy smoker and had a past medical history of hypertension, emphysema, asthma, ischemic heart disease and nephroangiosclerosis. A thoracic computed tomography (CT) revealed the presence of a middle lobe 3 cm mass, with omogeneous contrast enhancement and without calcifications or peripheral retraction, suggesting a

Conclusion

SR of cancer is the disappearance of a malignant disease, without adequate treatment. SR, occasionally reported in few tumor types, is considered to be an exceptionally rare event in lung cancer, in spite of its global high incidence. Kappauf, in his review of the literature [3], reports only 11 cases of SR in NSCLC. In this series some patients had undergone surgery, with residual non-resectable, or low dose radiotherapy, and obtained a SR, also after developing metastasis. Only three patients

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H Kappauf et al.
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Ann. Oncol.
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Everson TC, Cole WH. Spontaneous regression of cancer. Philadelphia: WB Saunders;...

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Spontaneous regression (SR) of cancer is a rare phenomenon. SR is recognized as complete or partial disappearance of the disease after inadequate or no treatment. Although reports of this phenomenon have been documented for several malignancies, it is rare in patients with lung cancer. In most documented cases, diagnoses of SR were made based on only the radiologic findings. We herein report a case of complete SR of non-small cell lung cancer (NSCLC) that was pathologically proven using a resected specimen. Moreover, despite the local complete SR, the patient subsequently experienced an adrenal metastasis after surgery. To the best of our knowledge, this is the first report of a patient with NSCLC in whom complete regression of the primary site was observed, but in whom a distant metastasis became apparent. Both phenomena were pathologically proven. Our report suggests that both SR and tumor progression can proceed simultaneously.
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CASE REPORTComplete spontaneous remission of non-small-cell lung cancer: a case report

Abstract

Introduction

Section snippets

Discussion

Conclusion

Ann. Oncol.

CASE REPORT
Complete spontaneous remission of non-small-cell lung cancer: a case report