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Spontaneous remission of advanced progressive poorly differentiated non-small cell lung cancer: a case report and review of literature

Authors
  • Yoon, Hee-Young1
  • Park, Heae Surng2
  • Cho, Min Sun2
  • Shim, Sung Shin3
  • Kim, Yookyung3
  • Lee, Jin Hwa1
  • 1 Ewha Womans University, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, 25 Magokdong-ro 2-gil Gangseo-gu, Seoul, Seoul, 07804, Republic of Korea , Seoul (South Korea)
  • 2 Ewha Womans University, Department of Pathology, College of Medicine, 25 Magokdong-ro 2-gil Gangseo-gu, Seoul, 07804, Republic of Korea , Seoul (South Korea)
  • 3 Ewha Womans University, Department of Radiology, College of Medicine, 25 Magokdong-ro 2-gil Gangseo-gu, Seoul, 07804, Republic of Korea , Seoul (South Korea)
Type
Published Article
Journal
BMC pulmonary medicine
Publication Date
Nov 11, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12890-019-0978-4
Source
Springer Nature
Keywords
License
Green

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.

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