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Spontaneous Regression Of Esophageal Carcinoma With Pulmonary Metastases: Case Report

Ohwada et al., 1990Esophageal cancer

Japanese Journal of Clinical Oncology 20(2): Jun 1990; 193-198. https://doi.org/10.1093/oxfordjournals.jjco.a039386

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Abstract

The first description of a spontaneous regression of a primary esophageal carcinoma with progressive growth of multiple pulmonary metastases is reported, and the possible cause of the spontaneous regression is discussed briefly with reference to T cell subsets. A 78-year-old Japanese man underwent an esophageal bypass with gastric substitution for carcinoma of the middle to lower third of the intrathoracic esophagus with aortic invasion. Two months after the operation, multiple pulmonary metastases were documented and were seen to progress gradually over the next six months. Seven months later, all the secondary lesions underwent a complete spontaneous regression. The primary lesion also regressed, but did not disappear completely. It was not possible to establish whether a change in T cell subsets was the cause or an effect of the regression.

Case Details

Personal Characteristics

78-year-old japanese man, history of a left cerebral infarction with residual left hemiplegia

Clinical Characteristics

Dysphagia, elevated serum squamous cell carcinomarelated antigen (SCC) level, long area of stenosis and a filling defect at the middle to lower third of the intrathoracic esophagus, borrmann 3 type carcinoma, thickening of the esophageal wall and invasion to the descending thoracic aorta, multiple pulmonary metastases, high temperature (over 38°c)

Remission Characteristics

Complete spontaneous regression of secondary lesions and partial regression of primary lesion, reduction in serum SCC levels

Treatment & Mechanisms

Proposed Remission Mechanisms

Possible change in t cell subsets

Clinical Treatment

Esophageal bypass with gastric substitution, feeding gastrostomy, antibiotics

Non-Clinical Treatment

Clinimeal (eisai co., ltd.) alone: an elementary diet

Additional Notes

The patient is well and at home, and his regression has lasted one year and two months to date: June 1989.