Spontaneous Regression Of Recurrent Undifferentiated Carcinoma Of The Endometrium
Ishii, T., Takayama, S., Abe, M., Kuroda, H., Tanaka, J., Numata, T., Kikuchi, A., Ohsawa, M., Kaneko, S., Saito, N., Arita, R., & Itakura, Y. (2019). Spontaneous Regression of Recurrent Undifferentiated Carcinoma of the Endometrium. Internal medicine (Tokyo, Japan), 58(11), 1649–1653. https://doi.org/10.2169/internalmedicine.0376-17
View Original Source →Abstract
We herein report a very rare case of spontaneous regression of recurrent undifferentiated carcinoma of the endometrium. An 80-year-old woman had undergone total hysterectomy with bilateral adnexectomy for undifferentiated carcinoma of the endometrium. The cancer recurred locally 10 months after surgery and then metastasized to the lung and liver. After she and her family elected to receive supportive care without active treatment, the local recurrences dramatically decreased, and the metastases of the lung, liver, and peritoneum also disappeared. This case showed that spontaneous regression can occur even with malignant tumors showing an extremely poor prognosis, such as undifferentiated carcinoma of the endometrium.
Case Details
Disease Location
Uterus with metastases to liver, lung and peritoneum
Personal Characteristics
77-year-old woman underwent total gastrectomy for gastric cancer with stage iia (ptnm)
Clinical Characteristics
Abdominal CT performed 3 years after gastrectomy, at 80 years of age, demonstrated a tumor in the uterus. She underwent total hysterectomy with bilateral adnexectomy after clinical stage ib endometrial carcinoma was diagnosed. Postoperatively, a histological examination confirmed undifferentiated carcinoma of the endometrium local recurrences of carcinoma of the endometrium together with pleural effusion, ascites, and bilateral hydronephrosis were observed after 10 months. The cancer subsequently metastasized to the lung, liver, and peritoneum at 17 months after surgery. Nephrostomy tube was placed for hydronephrosis. 34 months post-recurrence abdominal surgery was performed again to treat strangulated intestinal obstruction. The laparotomy findings showed limited adhesions without any sign of peritoneal dissemination or other obvious recurrence of cancer. A cytological examination of the ascites showed no signs of malignancy.
Remission Characteristics
Follow-up CT at 38 months after surgery 28 months post-recurrence showed that all lung and peritoneal recurrences had disappeared, and that the liver and local recurrences had dramatically decreased in size. The laparotomy (34 months after recurrence) findings showed limited adhesions without any sign of peritoneal dissemination or other obvious recurrence of cancer. A cytological examination of the ascites showed no signs of malignancy.
Treatment & Mechanisms
Proposed Remission Mechanisms
Natural immunity against cancer.
Clinical Treatment
Hysterectomy with adnexectomy laparotomy biopsy
Non-Clinical Treatment
Stress-free lifestyle (not proposed as treatment but identified as a crucial factor)