Spontaneous Regression of a Hypernephroma | Spontaneous Remission Database

Abstract

Spontaneous regression of malignant tumours, wherein healing is complete or includes the larger part of a tumour, is very rare. Bashford estimated that it occurs but once in one hundred thousand cases. The case which came to our attention was a large tumour of the kidney which had undergone necrosis and calcification.

Case Details

Personal Characteristics

The patient was a woman of sixty-one years, whose symptoms were related to the gastrointestinal tract.

Clinical Characteristics

A large, fixed mass was palpable in the left upper abdomen; no pain nor tenderness was elicited. X-ray examination disclosed a retroperitoneal, calcareous, cystic mass in the left upper abdominal quadrant, displacing the spleen upward, forward, and laterally, with the stomach overlying it anteriorly. In the stomach, a large indentation was seen on the greater curvature, apparently resulting from the pressure of the mass. Pyelography showed the left kidney displaced downward, and it was thought that the mass could be visualized as lying above and behind the displaced kidney. The upper calices were dilated, and distorted, apparently by the pressure of this mass. The right kidney pelvis and calices were normal. Both kidneys were functioning normally and the urine contained no cells. The greater part of the mass, as seen by x-ray, was spherical in shape, with, however, a knob-like process the size of a small orange projecting from its lower extremity. The dimensions of the shadow were 8 1/2 x 5 1/2 inches.

Remission Characteristics

The entire mass was calcified, except for one small piece of soft tissue about the size of a marble found after careful search for material suitable for section.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

An exploratory operation was done by dr. Roscoe r. Graham, and a large retroperitoneal tumour was found, arising in the upper pole of the left kidney. It was readily removed en masse with the kidney. The patient made an uneventful postoperative recovery. No metastatic growths were discovered at operation nor on x-ray examination.

Additional Notes

The origin of the tumour was not definitely determined, although it was thought not to be a primary tumour of the kidney. The discovery of the small groups of typical nephroma cells definitely decided the diagnosis. Sections from the remaining portion of the kidney showed no evidence of tumour invasion. A small atrophic left adrenal gland was removed at operation, which was not involved in the tumour.