Case Of Spontaneous Regression Research Articles

Analyses of tertiary lymphoid structures observed in cases of Merkel cell carcinoma showing spontaneous regression.

Merkel cell carcinoma (MCC) is a high-grade skin cancer, but spontaneous regression is observed at a markedly higher frequency than in other carcinomas. Although spontaneous regression is a phenomenon that greatly impacts treatment planning, we still cannot predict it. We previously reported on the prognostic impact of the presence or absence of tertiary lymphoid structures (TLS) and of Merkel cell polyomavirus (MCPyV) infection. To learn more about the spontaneous regression of MCC, detailed analyses were performed focusing on spontaneous regression cases. We collected 71 Japanese patients with MCC including 6 cases of spontaneous regression. Samples were analysed by immunostaining, spatial single-cell analysis using PhenoCycler, and RNA sequencing using the next-generation sequencer (NGS). All 6 cases of spontaneous regression were positive for MCPyV. TLS was positive in all 5 cases analysed. Spatial single-cell analyses revealed that PD-L1-positive tumour cells were in close proximity to CD20-positive B cell and CD3-, 4-positive T cells. Gene set enrichment analysis between MCPyV-positive and TLS-positive samples and other samples showed significantly high enrichment of "B-cell-mediated immunity" gene sets in the MCPyV-positive and TLS-positive groups. In conclusion, TLS may play an important role in the spontaneous regression of MCC.

P19 Spontaneous regression of aleukaemic cutis leukaemia in a male infant

Abstract Introduction Congenital leukaemia is a rare haematologic disease presenting in the first 4-6 weeks of life. Affected children may present with systemic symptoms of fever, hepatosplenomegaly and skin infiltration in the form of leukaemia cutis. Prognosis is generally poor but some cases of spontaneous regression have been described. We report a case of a 5-week-old who had biopsy confirmed cutis leukaemia which went on to resolve spontaneously. Case A male infant developed widespread erythematous/violaceous patches and nodules in the first week of life. He remained systemically well. A skin biopsy at 5 weeks of age showed features of a malignant haematological infiltrate, favouring a myeloid/monocytic leukaemic process. Baseline bloods were normal including a blood film which did not show any evidence of blasts. Interestingly, following his biopsy, skin lesions began to improve with complete resolution of all skin lesions by six weeks of age. RNA fusion panel analysis of affected skin detected a PICALM::MLLT10 t(10;11) (p12;q14) fusion which is a rare but recurrent finding in acute lymphoblastic leukaemia . He continues monthly haematology surveillance and has remained disease free at 8 months. Conclusion Spontaneous regression of aleukaemic leukaemia cutis is a rare phenomenon. Patients require close ongoing surveillance as some may relapse with systemic disease after several years. Key to management of this case was prompt suspicion of leukaemia cutis and biopsy which enabled an accurate diagnosis despite the brief window of skin lesions and has subsequently enabled accurate genotyping and future rigorous surveillance in this child.

Spontaneous regression of large fetal antero-lateral neck cysts: A case report and literature review

The entity of fetal lateral cervical cysts is presented as an isolated anomaly or associated with other sonographic structural findings, sometimes being determined by chromosomal abnormalities. We report a case of spontaneous regression of large fetal anterolateral cervical bilateral cysts diagnosed by ultrasonography at 13 weeks. Complete resolution of cervical cysts was documented at 20 weeks. The patient reveals no concerning results to other assessments related to her pregnancy including first trimester bio-chemical screening, cell free fetal DNA testing, routine laboratory tests, ultrasound repeated evaluation of fetal growth and wellbeing. When fetal anterolateral cervical cysts are encountered as isolated finding, completely separated by nuchal translucency fluid collection, regardless of the cystic diameter and bilaterally, the rules are normal karyotype, high rate of total regression and preservation the good pregnancy outcome.

Intra-abdominal lymphatic malformation management in light of the updated International Society for the Study of Vascular Anomalies classification.

The International Society for the Study of Vascular Anomalies (ISSVA) classification distinguishes between common lymphatic malformations and complex lymphatic anomalies. These entities have overlapping features but differing responses to treatment. Surgery has been the mainstream treatment in intra-abdominal lymphatic malformation, with variable reported success in the literature. The aim of this study was to review the outcome of different treatments for intra-abdominal lymphatic malformations in children. We retrospectively reviewed all intra-abdominal lymphatic malformations from 1999 to 2019 in children treated by the surgical team or followed in the vascular anomalies clinic of our institution. Children were classified into one of three groups: group A, isolated intra-abdominal lymphatic malformation; group B, common lymphatic malformation in continuity with other regions; or group C, intra-abdominal involvement as part of a complex lymphatic anomaly or associated syndrome. Fifty intra-abdominal lymphatic malformations were diagnosed; five of these were excluded. In group A (n=28), the treatment was surgical resection (n=26) or sclerosing treatment (n=1), with one case of spontaneous regression; no recurrence was observed in 25 patients. In group B (n=7), three patients had partial resection and all had recurrence; four had sclerotherapy alone with good response. In group C (n=10), therapeutic options included surgery, sclerosing treatment and pharmacotherapy, with variable outcomes. The management of intra-abdominal malformations requires a team approach. Sclerotherapy is successful in treating macrocystic lymphatic malformation. Surgery is successful in treating isolated intra-abdominal common lymphatic malformation, albeit at times at the cost of intestinal resection, which could be avoided by combining surgery with preoperative sclerotherapy. With surgery there is often limited resectability, and therefore recurrence in intra-abdominal lymphatic malformations that are part of complex lymphatic anomalies associated with syndromes, or in common lymphatic malformations in continuity with other regions. Sclerotherapy is an effective modality in these instances along with pharmacotherapy.

Spontaneous Regression of Osteochondroma – A Rare Phenomenon

Background: Osteochondroma is a common benign bone tumour, but its spontaneous regression is a rare occurrence. The first case was reported by Hunter in 1786. And only 30 cases were found in literature to date. Spontaneous regression of osteochondroma usually occurs in paediatric age group prior to skeletal maturation without any sequelae. The exact pathophysiology of its spontaneous regression is still not fully understood. We report a case of spontaneous regression of osteochondroma in a child after a 6-year period of follow up without needing any surgical intervention.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 372-374

Two Cases of Spontaneous Regression of Congenital Cholesteatoma

Two Cases of Spontaneous Regression of Congenital Cholesteatoma

Spontaneous regression of Markel cell carcinoma in anterior mediastinum without cutaneous involvement

AbstractBackground:Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine malignancy typically involving the skin. The majority of MCC involves the head/neck region and the extremities. Despite the aggressive nature of the disease, there have been several case studies that report spontaneous regression. We report a unique case of spontaneous regression of an MCC in a peculiar region in the anterior mediastinum with no cutaneous involvement.Methods:A 50-year-old man who presented with a mobile low anterior neck mass, proven by biopsy, to be MCC. Subsequent PET/CT confirmed an FDG (Flurodeoxyglucose)-avid upper mediastinal mass. The mass gradually regressed over the course of 1 month subsequent to biopsy and was no longer palpable on exam or visible on subsequent CT scans. The patient was treated with intensity modulated radiation therapy with a total dose of 6,160 cGy in 28 fractions to the site of previously visible primary disease. At-risk nodal basins were also treated. On subsequent follow-up, the patient continued to have no clinical or radiographic signs of disease.Discussion:Spontaneous regression of an MCC is rare but has been reported mostly in the head/neck region following biopsy. It is unknown why spontaneous regression occurs. There is a possibility that biopsy may stimulate T-lymphocytes resulting in spontaneous regression.Conclusion:This is the first case to our knowledge of spontaneous regression of an MCC in the anterior mediastinum with no cutaneous involvement. Most MCC are seen clinically due to skin changes with a majority of cases occurring in the head/neck region.

Resolving mystery behind autonomous retrogression of low-grade gliomas: A systematic review.

To review evidence-based data on spontaneous retrogression of low-grade gliomas with respect to interval till regression, type of glioma and patient outcome. The systematic review comprised medical literature in English language published from January 1997 to January 2017 on Scopus, PubMed and Google Scholar databases to establish consensus about the possible mechanism of spontaneous regression, the role of therapeutic intervention and failure of management strategies in low-grade gliomas. Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed during the review. Of the 176 articles identified, 73(41.5%) were shortlisted for detailed assessment. Of them, 10(13.7%) were included; 5(50%) case reports and 5(50%) case series. There were 23 cases of spontaneous regression; 15(65.2%) males and 8(34.7%) females. The interval of regression varied from 3 months to 15.5 years, and the most commonly presenting low-grade glioma type was optic pathway glioma 11(47.4%). The phenomenon of regression was most evident in optic pathway glioma. Literature suggested that low-grade gliomas should undergo serial imaging before implying any therapeutic intervention. However, the evidencebased proof, large-scale experimental studies and ethical considerations are still required to standardise this strategy.

Spontaneous Regression and Resolution of Breast Implant-Associated Anaplastic Large Cell Lymphoma: Implications for Research, Diagnosis and Clinical Management

First described in 1997, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was recognised by the World Health Organisation in 2016 as a specific disease. It typically presents as a late seromacontaining atypical, monoclonal T cells which are CD30+ and anaplastic lymphoma kinase negative. Until recently, it was thought that the disease was very rare. However, it is being diagnosed increasingly frequently with 56 cases confirmed in Australia by September 2017 and the estimated incidence revised from 1 in 300,000 to between 1 in 1000 and 1 in 10,000 patients with bilateral implants. There is debate about the spectrum of BIA-ALCL. According to the current WHO classification, BIA-ALCL is a cancer in all cases. Treatment guidelines require that it is treated urgently with a minimum of bilateral removal of implants and capsulectomies. Whilst acknowledging the disease has been under diagnosed in the past, with some notable exceptions the BIA-ALCL literature has given scant attention to the epidemiological evidence. Now that it is known that the disease may occur in up to 1 in 1000 patients with a median of 7.5 years from implantation to diagnosis, understanding it in its epidemiological context is imperative. The epidemiology of cancer and lymphoma in women with breast implants strongly suggests that most patients do not have a cancer that will inevitably progress without treatment but instead a self-limiting lympho-proliferative disorder. Although the possibility of spontaneous regression has been raised and the observation made that treatment delay did not seem to increase the risk of spread, the main objection to the lympho-proliferative hypothesis has been the lack of documented cases of spontaneous regression or resolution. Because all cases currently are considered malignant and treated urgently, only case report evidence, interpreted in the proper epidemiological context, is likely to be available to challenge this thinking. New observations and interpretation of the epidemiology of BIA-ALCL are made. These are supported by the presentation of two cases, which to the best of our knowledge comprise the first documented evidence of spontaneous regression and spontaneous resolution of confirmed BIA-ALCL. The epidemiology of the disease strongly suggests that the vast majority of cases are not a cancer that will inevitably progress without treatment. The findings presented in the manuscript provide supportive clinical evidence. Consequently, an alternative view of BIA-ALCL with implications for research, diagnosis and clinical management needs to be considered. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Is It Possible To Induce The "Spontaneous Regression" Of Cancer? A Mechanism of Activation for the Innate Immune Response

The article deals with a theoretical model  of the mechanism of the spontaneous regression of tumor, involving the activation of innate immune response. After stimulation the cells of the immune system, use glycolysis for ATP synthesis.  Lactic acid, the final product of glycolysis, acts as inhibitor of such activation. Therefore, highly glycolytic cancerous cells form the environment (hypoglycemia with high level of lactic acid), which is strongly inhibitory to immune cells activation. Starvation, KD (ketogenic diet) and Coley’s toxin induce hypoglycemia and in the long term should also lower lactic acid level. After a few days of such treatment the glucose level could increase naturally due to gluconeogenesis or by the application of significant dose of glucose. Such procedure should induce activation of immune cells response (high glucose and low lactic acid levels) and a spontaneous regression of cancer. If lactic acid concentration remained still too high and thus inhibit the activation of immune cells, the organism would require alkalization because sodium lactate is not inhibitory to the activation of immune cells. The model explains the cases of spontaneous regression described in literature and could be easily verified experimentally.

A Case of Spontaneous Regression of Idiopathic Bilateral Adrenal Hemorrhage in a Middle Aged Woman: 1 Year Follow-up

A Case of Spontaneous Regression of Idiopathic Bilateral Adrenal Hemorrhage in a Middle Aged Woman: 1 Year Follow-up

Spontaneous Regression of Primitive Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is a rare, aggressive skin tumor that mainly occurs in the elderly with a generally poor prognosis. Like all skin cancers, its incidence is rising. Despite the poor prognosis, a few reports of spontaneous regression have been published. We describe the case of a 89-year-old male patient who presented two MCC lesions of the scalp. Following biopsy the lesions underwent complete regression with no clinical evidence of residual tumor up to 24 months. The current knowledge of MCC and the other cases of spontaneous regression described in the literature are reviewed.

Spontaneous Involution of a Presumably Rathke's Cleft Cyst in a Patient with Slight Subclinical Hypopituitarism: A Case Report and Review of the Literature.

Rathke cleft cyst is described as benign intrasellar cyst. They are mostly small and asymptomatic; they may become large enough to cause symptoms by compression of intrasellar or suprasellar structures. We report on a case of spontaneous regression of a symptomatic RCC with subsequent recovery of preexisting endocrine dysfunction and resolution of headaches. A 60-year-old man complained about headaches. Laboratory investigation revealed a partial hypopituitarism with a slight central hypothyroidism without need for substitution. An MRI study showed a cystic, T2-hyperintense, sellar lesion compatible with a RCC. At one year follow-up, the patient had no complaints and the hormone work-up revealed a regression of the previous slight hypopituitarism. The MRI study showed a complete regression of the cystic lesion and a normal sized and shaped pituitary gland. The spontaneous regression of cystic sellar lesions is rare. The exact mechanism of the possible spontaneous involution of RCC is until now not well understood. However, spontaneous regression is possible and justifies the conservative therapy with regular clinical and radiological follow-up for asymptomatic patients or patients with symptoms not caused by the mass effect of these lesions.

肝膿瘍の併発と同時期に縮小した肺扁平上皮癌の1例

肝膿瘍の併発と同時期に縮小した肺扁平上皮癌の1例

上下顎に発生し自然消退した先天性エプーリスの1例

上下顎に発生し自然消退した先天性エプーリスの1例

A ganglion cyst of the temporomandibular joint.

A ganglion cyst of the temporomandibular joint.

Abstract 3108: Copy number variation analysis in neuroblastoma through next generation sequencing data and SNP-microarray

Abstract The childhood cancer neuroblastoma show high degree of clinical heterogeneity ranging from aggressive tumors with fatal outcome to cases of spontaneous regression. Analysis of recurrent chromosomal aberrations such as losses of 1p, 11q, gain of 1q, 17q and/or MYCN amplification are currently used for patient stratification and definition of therapeutic strategy. Different analysis techniques for detection of segmental abnormalities include FISH, CGH-microarrays or multiplex ligation-dependent probe amplification (MLPA). However, as next-generation sequencing (NGS) becomes available for clinical use, this could also be used for assessment of copy number alterations simultaneously with mutational analysis. In this study we compare genomic profiles generated through the bioinformatical tool Control-FREEC on Exome sequencing data with profiles generated from Affymetrix 250K or 50K SNP-microarrays on 20 NB tumors of different stages. Exome sequencing was performed by paired-end sequencing on Illumina instrumentation after DNA enrichment with Agilent SureSelect All Exome. The sequencing were performed at three separate occasions with a median raw coverage of 91X, 127X and 340X respectively. Neuroblastoma tumors were normalized with either corresponding constitutional DNA or normal control DNA for NGS data while microarrays were normalized against healthy control DNA. Gross genomic changes were extracted through visual and/or ratio inspection from 20 neuroblastoma tumors. A total of 128 larger segmental aberrations and 63 numerical aneuploidies were detected trough SNP-microarrays. Discrepancies between the two methods were detected in three cases; one segmental loss detected through microarray could not be confirmed by NGS-profiling, one smaller deletion were only detected through NGS-profiling and in one instance both methods indicated 2p-gain but at different positions. Otherwise the results were concordant. Furthermore, through exome sequencing data were we also able to detect ALK mutations in four patients, ATRX-deletions in two patients and chromothripsis of chromosome 5 in one patient. In conclusion, exome sequencing could be used as a new diagnostic tool for neuroblastoma tumors combining mutational screening with detection of common chromosomal and segmental aneuploidies such as 2p-gain, 17q-gain, 11q-deletion as well as MYCN-amplification and alterations of ALK or ATRX. Citation Format: Susanne Fransson, Malin Östenssson, Anna Djos, Niloufar Javanmardi, Per Kogner, Tommy Martinsson. Copy number variation analysis in neuroblastoma through next generation sequencing data and SNP-microarray. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3108. doi:10.1158/1538-7445.AM2014-3108

Quantitative Measurements of Cerebral Circulation in Spontaneously Regressing Traumatic Carotid-Cavernous Sinus Fistula with Velocity-Encoded Magnetic Resonance Imaging

and quantitative evidence for whether endovascular occlusion would remove the shunts connected to extradural venous drainage alone, or further resolve the disturbance of cerebral venous flow. It is not known how cerebral vessels would change in the long-term as a result of obstructing this shunt flow, or how the clinical symptoms are related to the haemodynamic changes in the rare cases of spontaneous regression. The understanding of the pathophysiology of CCF can be enhanced by correlating the clinical symptoms and MRI findings during a long observational period. Velocity-encoded magnetic resonance imaging (VENCMRI) has shown excellent diagnostic accuracy and reliability for the measurement of the flow volumes (FVs) in cerebral vessels [12]. Furthermore, VENC-MRI does not require contrast medium administration or invasive catheterization, and is considered a safe and appropriate followup imaging technique [13]. However, this tool has never been used for quantifying the shunt volume and cerebral circulation related to CCF. A case in which VENC-MRI was used to measure the shunt volume of and FVs in the cerebral vessels in a direct CCF patient is presented herein. The temporal changes during spontaneous regression are demonstrated, and the relationships between the patient’s clinical symptoms and the measured cerebral haemodynamics are discussed.

More on spontaneous regression of chronic lymphocytic leukemia: two new cases and potential role of lamivudine in a further patient with advanced disease and hepatitis B virus infection

We read with interest the article by Nakhla et al. that appeared recently in Leukemia and Lymphoma, reviewing the published cases of spontaneous regression (SR) of chronic lymphocytic leukemia (CLL...

傍腫瘍性辺縁系脳炎を合併し，自然退縮傾向を呈した肺小細胞癌の1例

傍腫瘍性辺縁系脳炎を合併し，自然退縮傾向を呈した肺小細胞癌の1例