Spontaneous Regression Of Malignant Tumors; Report Of A Twelve-year Spontaneous Complete Regression Of An Extensive Fibrosarcoma, With Speculations About Regression And Dormancy
American Journal of Surgery 92: Aug 1956; 162-173
View Original Source →Abstract
Malignant tumors frequently show fluctuation in rate of growth. Some have periods of very slow and then rapid growth. Some are slow to metastasize or the metastases may be dormant for many years. There are a few proved cases of malignant tumors that have completely regressed without any therapy. Most of the cases reported as spontaneous cures cannot be accepted when examined critically. To aid in the segregation of cases of complete spontaneous regression, a list of criteria is proposed. A case is reported of a girl who had an extensive fibrosarcoma when five months of age, received no treatment and is now entirely well at thirteen years of age. A list of possible factors concerned in spontaneous regression of malignant tumors is presented. The various theories which have been suggested to explain late recurrence and metastasis are discussed. The variability of growth of all types of malignant tumors must be considered when evaluating a particular type of therapy or in estimating the prognosis.
Case Details
Personal Characteristics
A girl WHO had an extensive fibrosarcoma when five months of age, received no treatment and is now entirely well at thirteen years of age.
Clinical Characteristics
A large tumor in the left upper thigh and lower abdomen. The upper left thigh was about 50% larger than the right, and on palpation there was a 9 by 7 centimeter rather soft, deep-seated mass extending downward below the left inguinal ligament. Abdominal palpation revealed a firm, fixed mass extending upward from the left iliac fossa laterally in the flank to above the left costal margin. The mass in the thigh seemed to be an extension of the abdominal mass.
Remission Characteristics
The child was followed up regularly and the masses continued to recede until eighteen months after the biopsy when no masses were palpable.
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
The mass in the thigh was biopsied through a long incision. A diffuse, pink, vascular tumor was encountered which was invading muscle and had surrounded femoral vessels and nerve. A frozen section was examined and found to be a malignant tumor, some type of a spindle cell sarcoma.
Additional Notes
The diagnoses considered at that time were: (1) sarcoma of some type, (2) hemangioma or lymphangioma and (3) lipoma. The subsequent week the case was presented to the Stanford Tumor Board. It was decided not to use x-ray therapy because the sarcoma was well differentiated and unlikely to respond to radiation; a high dose over so large an area in the abdomen and thigh could not be borne. A safe dose would have been ineffective and would merely have made the baby very sick.