Spontaneous Regression Of A Large-cell Lymphoma In The Conjunctiva And Orbit
Chang, Y. C., Chang, C. H., Liu, Y. T., Tsai, K. B., Liu, T. C., & Lin, Y. N. (2004). spontaneous regression of a large-cell lymphoma in the conjunctiva and orbit. Ophthalmic plastic and reconstructive surgery, 20(6), 461–463. https://doi.org/10.1097/01.iop.0000144791.05993.64
View Original Source →Abstract
Spontaneous and complete regression of malignant neoplasms is extremely unusual. To our knowledge, this case report is the first description of spontaneous regression of an extranodal malignant lymphoma occurring in the conjunctiva and orbit. A 40-year-old woman noticed a pink conjunctival mass at the medial aspect of her left eye that had been present for 3 weeks. She presented on May 5, 2003. Ophthalmologic examination showed a salmon-colored mass along the lateral side of the caruncle. CT revealed a mass in the medial orbit. Surgical biopsy exhibited a malignant lymphoma, diffuse large B-cell type. After biopsy, the tumor spontaneously decreased in size and completely disappeared in 5 weeks. At 6 months' follow-up, the tumor had not recurred.
Case Details
Disease Location
Left conjucntiva and orbit
Personal Characteristics
40 -year-old female may 2003 hepatitis b carrier
Clinical Characteristics
Patient had a pink conjunctival mass on the medial aspect of her left eye for 3 weeks and stated it was increasing in size ophthalmologic exam revealed a relatively flat lesion with a smooth surface and a sal months pink appearance growing along the lateral side of the caruncle. Orbital CT scan showed an ill-demarcated, soft tissue density mass in the medial part of the left orit with a clear retrobulbar fat space incisional biopsy and histopathologic findings found monotonous diffuse lymphocytic infiltration within the submucosa and tumor cells containing round hyperchromatic nuclei and scanty cytoplasm with an abundance of mitotic figures. Immunohistochemical exam revealed diffuse positive leukocyte common antigen and l-26 and scattered positive cd45ro. There was also diffuse positive stain with CD20, scattered positive CD3, positive for lambda-light chain and negative for kappa-light chain, and a high ki-67 proliferation index. Malignant lymphoma, diffuse large b-cell type was established blood count, chest radiography, abdominal echography and CT were unremarkable. Ga-67 citrate whole-body scan showed increased radioactivity in the left orbital area
Remission Characteristics
After the biopsy, the tumor decreased in size and the sal months pink mass completely disappeared after 5 weeks without medication follow-up CT of the orbit in september 2003 showed complete regression of the tumor on the medial aspect of left orbit
Treatment & Mechanisms
Proposed Remission Mechanisms
Immune modulation tumor inhibition by cytokines or growth factors elimination of cerightain carcinogens induction of differentiation tumor necrosis or inhibition of angiogenesis apoptosis ***reduction of tumor load by biopsy and activation of the host immunity by surgical intervention***(this case)
Clinical Treatment
Biopsy
Non-Clinical Treatment
None reported