Spontaneous Regression Of A Metastatic Melanoma Pulmonary Deposit Following Biopsy
Behnia, F., Zare, M., & Elojeimy, S. (2018). spontaneous regression of a metastatic melanoma pulmonary deposit following biopsy. Radiology case reports, 13(3), 580–582. https://doi.org/10.1016/j.radcr.2018.02.012
Abstract
Spontaneous complete and partial regression of metastatic melanoma is poorly understood, and is a rare phenomenon with less than 80 cases reported since 1866. Several correlations have been noted such as systemic or local infections, operative trauma, hormonal influences, nutrition and immunologic factors. We present FDG PET and CT findings in a patient with multiple pulmonary metastases of melanoma, one of which underwent regression following biopsy. We suggest immune system modulation, triggered by biopsy, could have played a role, although the precise mechanism remains unknown.
Case Details
Disease Location
Melanoma mets to lung
Personal Characteristics
55 -year-old female, remote history of being homeless
Clinical Characteristics
Presented with night sweats, cough, and hemoptysis. Chest x-ray showed a well-defined round opacity in the left lower lobe, CT scan of the chest was performed 10 days later for further characterization. In addition to the left lower lobe pulmonary nodule, smaller cavitary lesions were seen in the bilateral upper lungs. A CT-guided biopsy of the left lower lobe nodule was positive for metastatic melanoma. PET-CT were obtained to assess the extent of metastatic disease 43 days after CT. The bilateral upper lobe cavitary lesions had increased in size and number and were markedly hypermetabolic. The previously biopsied left lung nodule has decreased in size and showed very minimal fdg uptake
Remission Characteristics
Regression of lll mass 43 days after biopsy
Treatment & Mechanisms
Proposed Remission Mechanisms
Proposed inflammation after biopsy immune therapy with ipilimumab (for melanoma)
Clinical Treatment
Biopsy