Abstract
BackgroundSpontaneous remission (SR) of cancer is a very rare phenomenon of unknown mechanism. In particular, SR of non-small cell lung cancer (NSCLC) has been scarcely reported. We present the case of a 74-year-old woman with advanced, poorly differentiated NSCLC (highly expressing programmed death ligand-1 [PD-L1]) that progressed despite multiple lines of chemotherapy but then spontaneously remitted.CASE presentationThe patient presented with hemoptysis and was diagnosed with stage IIIA poorly differentiated NSCLC via bronchoscopic biopsy. She had an unremarkable medical history and moderate performance status. The initial treatment plan was surgery after neoadjuvant chemotherapy. Despite conventional chemotherapy, follow-up chest computed tomography (CT) showed gradual tumor progression and she decided against further treatment after fifth-line chemotherapy. However, the size of lung mass was markedly decreased on follow-up chest CT one year after ceasing chemotherapy. Also, follow-up positron emission tomography images showed decreased metabolic activity in the lung mass and a percutaneous biopsy specimen from the diminished lung mass revealed no viable tumor cells. A diagnosis of SR of NSCLC was confirmed, and the patient was without tumor progression on follow-up nine months later. Later, PD-L1 immunostaining revealed high positivity (> 99%) in initial tumor cells.ConclusionOur case showing SR of poorly advanced NSCLC refractory to multiple lines of chemotherapy suggested the association between immunity and tumor regression.
Highlights
Spontaneous remission (SR) of cancer is a very rare phenomenon of unknown mechanism
Our case showing SR of poorly advanced non-small cell lung cancer (NSCLC) refractory to multiple lines of chemotherapy suggested the association between immunity and tumor regression
* Correspondence: jinhwalee@ewha.ac.kr 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul25 Magokdong-ro 2-gil Gangseo-gu, Seoul 07804, Republic of Korea Full list of author information is available at the end of the article case of a 74-year-old woman diagnosed with advanced poorly differentiated NSCLC that spontaneously remitted after failure of multiple courses of chemotherapy
Summary
Spontaneous remission (SR) of cancer is a very rare phenomenon of unknown mechanism. In particular, SR of non-small cell lung cancer (NSCLC) has been scarcely reported. Conclusion: Our case showing SR of poorly advanced NSCLC refractory to multiple lines of chemotherapy suggested the association between immunity and tumor regression. Bladder cancer, and lymphoma have shown relatively high incidences of SR [2], SR of non-small cell lung cancer (NSCLC) is rare, with only a few cases reported worldwide [3–19].
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