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Spontaneous Regression In Small Cell Esophageal Carcinoma.

Kubota, M. 2003Esophageal cancer

Kubota, M., Sueyoshi, S., Fujita, H., Fujii, T., Yamana, H., & Shirouzu, K. (2003). spontaneous regression in small cell esophageal carcinoma. The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi, 51(12), 660–664. https://doi.org/10.1007/s11748-003-0005-8

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Abstract

Spontaneous regression or remission of cancers has been defined as the disappearance of the malignancies without any treatment or with obviously inadequate treatment. Spontaneous regression is rare, while any case with a small cell carcinoma in the esophagus was not found in the literature. We experienced a 73-year-old man with small-cell carcinoma in the thoracic esophagus whom underwent esophagectomy with lymphadenectomy. A pathological examination of the resected specimens found metastasis from the small cell carcinoma in the mediastinal lymph nodes, but no malignant cells in the esophageal lesion--an ulcer scar from which the biopsy specimen was taken to be a small-cell carcinoma. This may be the first case report that spontaneous regression in a small-cell carcinoma in the esophagus was found by esophagectomy and pathological examination.

Case Details

Disease Location

Liver

Personal Characteristics

73-year-old man, diabetes mellitus controlled by insulin, and chronic hepatitis type c

Clinical Characteristics

Presented with dysphagia, the laboratory examination revealed mild liver dysfunction, hypoalbuminemia and hyperglycemia, tumor markers were normal. Contrast esophagography with barium feed showed an ulcerative tumor 6.5 cm in length in the middle thoracic esophagus, esophagoscopy revealed an ill-defined ulcerative lesion surrounded by slight elevation covered by epithelium in the esophagus between 30 and 35 cm from the incisor teeth. Biopsy showed histological findings of undifferentiated carcinoma small-cell type. From these findings, we diagnosed that this case had a small cell carcinoma in the thoracic esophagus at t3 nt mo, stage iii. The patient underwent esophagectomy with lymphadenectomy. Pathological examination of the resected specimens found metastasis from the small-cell carcinoma in the left recurrent nerve node, infraaortic node, and in the left cardiac node

Remission Characteristics

Pathological examination of the esophagus did not show malignant cells.

Treatment & Mechanisms

Proposed Remission Mechanisms

Immune mechanism

Clinical Treatment

Intravenous injection of glycyears-rhizin and peroral ursodesoxycholic acid (for hep c infection). Esophagectomy with lymphadenectomy. Postoperative adjuvant chemo- therapy