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Apparent Spontaneous Regression Of Malignant Neoplasms After Radiography: Report Of Four Cases

Sasaki et al., 2016Thyroid cancer

Sasaki, J., Kurihara, H., Nakano, Y., Kotani, K., Tame, E., & Sasaki, A. (2016). Apparent spontaneous regression of malignant neoplasms after radiography: report of four cases. International journal of surgery case reports, 25, 40–43. https://doi.org/10.1016/j.ijscr.2016.05.049

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Abstract

INTRODUCTION: On rare occasions, an apparently spontaneous regression of unknown etiology is observed in a neoplasm. We report a series of 4 patients with apparent spontaneous regression of malignant lymphomas after radiography. PRESENTATION OF CASE: All four of the tumors were malignant lymphomas. The regressions occurred between 1 and 2 months after the radiographic examinations. All four patients later underwent relapse and needed additional treatments: surgery, chemotherapy and/or radiation. DISCUSSSION: Four cases had the following features in common: (1) the neoplasms were radiosensitive, (2) the regression occurred after radiography, (3) none of the neoplasms was in the advanced stage, and (4) the doses received through radiographic exposure were a little higher than usual because CT was included for most of the patients. CONCLUSION: We suspect that the apparently spontaneous regression of malignant lymphomas was caused by the small radiation doses received in the radiographic examinations.

Case Details

Disease Location

Patient 1) front of neck, left lobe of thyroid

Personal Characteristics

69 -year-old female

Clinical Characteristics

Tumor was noticed 2 weeks before visiting the clinic. The tumor grew rapidly. The left lobe of the thyroid was hard and was enlarged to 35cm and had smooth surface with a silhouette defect appearing in the scintigram, had a solid homogenous low-density area in the ultrasound and a low-density area in the CT two adjacent enlarged lymph nodes were palpated findings suggested a malignant thyroid lymphoma core biopsy diagnosis was hashimoto's disease, so regular radiotherapy was refused after the tumor shrinkage, a month later had grown again reaching approx. The former maximum size. Left hemithyroidectomy with dissection of the cervical lymph nodes was performed, the thyroid was observed to adhere to the surrounding tissues histological exam found a medium-sized diffuse malignant b-cell lymphoma with lymph node metastases fibrosis was found in this lymphoma forighty gray (gy) of post-op radiation was administered

Remission Characteristics

Two months later, the tumor shrank to about half of its original size 21 years later, the patient is healthy and hasn't had any recurrence

Treatment & Mechanisms

Proposed Remission Mechanisms

The lymphoma was radiosensitive, and size was reduced due to small-dose radiation from radiographic procedures

Clinical Treatment

Hemithyroidectomy forighty gray

Non-Clinical Treatment

None reported