Spontaneous Regression Of Pancreatic Cancer: A Case Report And Literature Review.
Chin, K. M., Chan, C. Y., & Lee, S. Y. (2018). spontaneous regression of pancreatic cancer: A case report and literature review. International journal of surgery case reports, 42, 55–59. https://doi.org/10.1016/j.ijscr.2017.11.056
View Original Source →Abstract
INTRODUCTION: Spontaneous regression of cancer is defined as the partial or complete disappearance of malignant disease without treatment, or in the presence of therapy that is deemed inadequate to exert an influence on malignant disease, as composed by Tilden Everson and Warren Cole in the 1960s. It has been a topic of major interest in the field of medical and surgical oncology. It is poorly understood and scantily documented. Factors associated and postulated pathogeneses are at best, hypothetical. PRESENTATION OF CASE: We report a case of spontaneous resolution of a head of pancreas carcinoma in a 77-year-old gentleman after a myocardial infarction event delayed planned surgery. DISCUSSION: A literature review of previously reported cases of spontaneous regression of pancreatic cancer was performed. The possible predisposing factors to spontaneous regression of pancreatic and other forms of malignancies was reviewed. CONCLUSION: This is a novel case of spontaneous regression of pancreatic carcinoma after an episode of myocardial infarction. The pathophysiology to spontaneous resolution of cancer is not well understood, may be multifactorial and requires further study.
Case Details
Disease Location
Pancreas
Personal Characteristics
77-year old male
Clinical Characteristics
Two-week history of jaundice, pruritus, bruising, tea-colored urine, unintentional weight loss of 13kg over past year and loss of appetite physical exam showed scleral icterus and right hypochondriac mass palpable approx 2-3cm inferior to left costal margin, liver function test showed elevated total serum bilirubin 131 umol/l, alanine transaminase 300u/l, aspartate transaminase 217 u/l and alkaline phosphatase 964 u/l, carbohydrate antigen 19-9 was elevated at 227 u/ml; CT scan showed marked dilation of intrahepatic and common bile ducts with abrupatient cutoff proximal to 4.0x4.4cm ill-defined hypovascular mass in pancreatic head; patient opatiented for surgery to remove tumour but first had to undergo carotid endarterectomy and suffered non-st elevated myocardial infarction post-procedure complicated by pulmonary edema
Remission Characteristics
4 weeks after initial diagnosis, patient's lft improved and normalized without biliary decompression over the next 4 months and ca1909 levels were down-trending and normalized within next two months; ctap scan 4 months after diagnosis showed that tumour was no longer present, PET-CT showed absense of any appreciable fluorodeoxyglucose avid focus in pancreas; ctap scan 10 months after diagnosis was normal
Treatment & Mechanisms
Proposed Remission Mechanisms
Possibly related to myocardial infarction
Clinical Treatment
Carotid endarterectomy prior to scheduling surgery to remove tumour treatment for myocardial infarction after surgery