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

Title
Spontaneous remission of advanced progressive poorly differentiated non-small cell lung cancer: A case report and review of literature
Authors
Yoon H.-Y.Park H.S.Cho M.S.Shim S.S.Kim Y.Lee J.H.
Ewha Authors
김유경조민선이진화심성신박혜성윤희영
SCOPUS Author ID
김유경scopus; 조민선scopus; 이진화scopus; 심성신scopus
Issue Date
2019
Journal Title
BMC Pulmonary Medicine
ISSN
1471-2466JCR Link
Citation
BMC Pulmonary Medicine vol. 19, no. 1
Keywords
Advanced stageChemotherapyDisease progressionImmunityPrognosis
Publisher
BioMed Central Ltd.
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Background: 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. 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 presentation: The 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. Conclusion: Our case showing SR of poorly advanced NSCLC refractory to multiple lines of chemotherapy suggested the association between immunity and tumor regression. © 2019 The Author(s).
DOI
10.1186/s12890-019-0978-4
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의과대학 > 의학과 > Journal papers
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