Transient Spontaneous Regression Of An Anterior Mediastinal Mass
Chest 87(4): April 1985; 547-548
View Original Source →Abstract
Two patients with primary malignant lymphoma underwent spontaneous regression. One was a 40-year-old woman with a large ulcerating tumor on the greater curvature of the gastric antrum. This tumor shrank spontaneously, leaving only a small shallow ulcer. The resected specimen showed a minute focus of malignant lymphoma in the ulcer base. The other was a 73-year-old man who had a tumor with central ulceration on the posterior wall of the gastric antrum. Endoscopic biopsy revealed a malignant lymphoma. This tumor disappeared 60 days later. The patient refused surgery and remains well with no evidence of recurrent disease at this writing, 44 months later. Although there have been several case reports of spontaneous regression, partial or complete, of gastric malignant lymphoma, our cases seem to be the ones best proven.
Case Details
Personal Characteristics
A 69-year-old woman
Clinical Characteristics
Shortness of breath and cough, anterior mediastinal mass, abdominal distention, pain, elevated white blood cell count, small bowel obstruction, reaccumulation of pleural effusion
Remission Characteristics
On a repeat roentgenogram of the chest, the mass was no longer visible on the 17th day of hospitalization, and a CT scan failed to demonstrate any mass lesion
Treatment & Mechanisms
Proposed Remission Mechanisms
Elevated circulating endogenous corticosteroids are thought to have acted against the tumor cells
Clinical Treatment
Percutaneous aspiration of the mass with an 18- gauge needle, laparotomy, lysis of adhesions and resection of 59 centimeters of small intestine, thoracotomy and biopsy
Additional Notes
The patient was discharged to be followed with serial chest x-ray films. Three weeks after discharge, the patient returned with reaccumulation of pleural effusion and reappearance of the anterior mediastinal mass