Programmed Death-ligand 1-positive Squamous Cell Carcinoma Spontaneously Regressed After Percutaneous Needle Biopsy
Sasahara, M., Takahashi, H., Ohchi, T., Nomura, N., Kodama, K., Ikeda, K., Nishikiori, H., Okamoto, K., & Chiba, H. (2023). Programmed Death-Ligand 1-Positive Squamous Cell Carcinoma Spontaneously Regressed after Percutaneous Needle Biopsy. Medicina (Kaunas, Lithuania), 59(3), 631. https://doi.org/10.3390/medicina59030631
View Original Source →Abstract
Spontaneous lung cancer regression is a very rare course of disease. A 60-year-old male patient was admitted to our hospital with pneumonia and a 19 mm-sized nodule shadow in the S4 of the left lung on chest computed tomography (CT). A percutaneous needle biopsy was performed, and a diagnosis of programmed death-ligand 1-positive squamous cell lung carcinoma was made based on pathological findings. The patient was followed up with imaging because the lesion has reduced in size on chest CT. We report the possibility that cellular immune mechanisms triggered by needle biopsy contributed to spontaneous regression.
Case Details
Disease Location
Lung
Personal Characteristics
60-year-old male. He had a pacemaker implanted for complete atrioventricular block, was on medication for chronic heart failure, and smoked 20 cigarettes per day for 42 years. He was diagnosed with malignant lymphoma 20 years ago
Clinical Characteristics
Symptoms of cough, sputum, and shortness of breath. Chest computed tomography (CT) showed an infiltration shadow of the lower lobe of the left lung and a nodule with irregular margins of 19 mm in length in the s4 of the left lung. The patient was diagnosed with pneumonia and was started on ceftriaxone. The patient was discharged after 14 days. 2 weeks later, he was readmitted for a biopsy of the lung nodule in s4. Pathology examination revealed tumor cell proliferation and positive immunostaining p40, p63, and cytokeratin (ck) 5/6. The diagnosis was squamous cell lung carcinoma.
Remission Characteristics
The lesion in s4 reduced 35 days after biopsy. The tumor continued to shrink until 20 months after the biopsy
Treatment & Mechanisms
Proposed Remission Mechanisms
The mechanical stimulation induced by biopsy suppressed the interaction of pd-1 and pd-l1 via an immunological mechanism that mimics immune checkpoint inhibitors, resulting in the shrinkage of tumor.
Clinical Treatment
Ceftriaxone, biopsy