Spontaneous Regression of Metastatic Pancreatic Cancer: A Role for Recurrent Inflammation

Case Details

Disease Location

Lymph nodes

Personal Characteristics

59-year-old-woman

Clinical Characteristics

Presented with a 2-week history of painless jaundice. CT scan of the abdomen and pelvis showed dilatation of the common bile duct and abrupt decompression at the level of the ampulla. She underwent a whipple procedure. Surgical pathology showed a 2-cm moderately differentiated pancreatic ductal adenocarcinoma. Her postoperative course was complicated by intra-abdominal abscess formation and septic shock. Repeat CT scans within 6 months showed interval development of retroperitoneal lymphadenopathy, and a new 4 x 3 cm necrotic lymph node (ln) within the right axilla. Biopsy confirmed metastatic pancreatic adenocarcinoma. One month later, computed tomography showed acute pancreatitis.

Remission Characteristics

A repeat CT chest 3 months later showed a spontaneous decrease by more than 20% in the size of the right axillary lymph node. Over the next 1 year, she had spontaneous regression of lymphadenopathy in the right axilla and retroperitoneum, documented by multiple CT scans

Treatment & Mechanisms

Proposed Remission Mechanisms

Acute pancreatitis and bacterial/fungal infect- tion in the vicinity of pancreatic tumor could have theoretically improved tumor present- tion to the immune system

Clinical Treatment

Biopsy