Complete Spontaneous Regression of Colorectal Cancer: A Report of Two Cases

Abstract

Spontaneous regression of cancer is rare, and rarer still in colorectal cancer. We present a report of two cases of spontaneous regression of histologically proven proximal colonic cancers described in detail, alongside endoscopic, histological, and radiological images. We discussed the potential mechanisms by reviewing previous literature.

Case Details

Disease Location

Colon

Personal Characteristics

86-year-old female. History of chronic lymphoid leukemia (cll), stage a low-level lymphocytosis

Clinical Characteristics

Referred with a change in bowel habits and loose bowel movements for several months. Colonoscopy demonstrated a cecal lesion suspicious for a carcinoma. This was noted to be a sessile polypoidal lesion with kudo type-5 pit pattern. Eight biopsies were taken consistent with a colonic adenocarcinoma with moderate differentiation. They showed colonic mucosa with a partly villous architecture, with high-grade dysplasia and areas of moderately differentiated adenocarcinoma. CT imaging showed large right common iliac nodes and small left iliac and para-aortic nodes. She underwent elective laparoscopic right hemicolectomy and iliac node biopsy

Remission Characteristics

Histological examination revealed no evidence of any significant mucosal lesion, tumor, or polyp. Thirteen lymph nodes were present, all negative for malignancy.

Treatment & Mechanisms

Proposed Remission Mechanisms

Local trauma could have stimulated inflammation and an immune response, or it could be that the biopsies removed the only focus of cancer.

Clinical Treatment

Biopsy