Long-Term Survival of Mother and Son with Widespread Metastatic Adenocarcinoma of the Colon

Abstract

A 65-year-old alcoholic man developed jaundice and biopsy-proven multicentric hepatocellular carcinoma. Coinciding with abstention from alcohol and without treatment, jaundice has resolved, alphafetoprotein has become normal, and there is no evidence of tumor demonstrable by radionuclide scanning or laparoscopic liver biopsy. The patient is alive and well 48 months after the initial diagnosis. Regression of this tumor in the untreated adult has not previously been reported.

Case Details

Personal Characteristics

Mother, db, WHO had mild rheumatoid arthritis, was admitted to the university hospitals of cleveland in january 1939 at age 62

Clinical Characteristics

Increasing constipation and a 30-pound weight loss

Remission Characteristics

Lived 14 1/2 years after the metastatic carcinoma was found. She died at age 78. No autopsy was performed. Her physician informed us that there was no clinical evidence of malignancy at the time of her death

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

The patient underwent exploratory laparotomy on january 20, 1939. The surgeon could not remove all the tumor. The surgeon’s notes (1/20/39) mentioned “tumor had penetrated to small bowel, bladder, uterus. Prognosis poor.” the patient’s postoperative course was complicated by wound infection which started on postoperative day 4 characterized by fever to 102°f for 10 days, with a maximum leukocytosis of 15,750/mm3. As antibiotics were not in use in 1939, she made a slow recovery, being discharged on february 12 of that year

Additional Notes

Spontaneous regression of carcinoma of the colon is extremely rare. The possible mechanisms in the two cases presented are discussed