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Spontaneous Regression Of Adenocarcinoma Of Submandibular Gland

Curioni, O. A. 2021Other/Unknown

Curioni, O. A., Andrade Filho, P., Prates, A. J., Rapoport, A., & Dedivitis, R. A. (2021). Spontaneous regression of adenocarcinoma of submandibular gland. Brazilian journal of otorhinolaryngology, 87(4), 486–488. https://doi.org/10.1016/j.bjorl.2020.10.014

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Abstract

he disappearance of a cancer without a satisfactory explaation is rarely accepted in the medical setting. This process s called ‘‘regression’’ or ‘‘spontaneous remission’’ and, in xceptional cases, patients are cured of the disease. The ormal definition as partial or complete disappearance of a alignant tumor in the absence of treatment or in the presnce of inadequate therapy was named by Dr. Tilden Everson nd Dr. Warren Cole in the 1960s.1 The incidence of spontaneous regression is estimated etween 1 in 60,000 to 140,000 cases of cancer, although t is very difficult to define it based on clinical aspects.2 The medical literature is rich in case reports of maligancies confirmed by pathologic exam, with computed omography (CT) or magnetic resonance imaging (MRI) howing generalized diseases with spontaneous regression, hich covers almost all types of cancers and histology.

Case Details

Disease Location

Submandibular gland

Personal Characteristics

51-year-old woman, history of smoking for 38 years

Clinical Characteristics

Consulted to evaluate a mass in the left submandibular region for the last 5 months, associated with worsening pain. On physical examination, there was facial asymmetry with a 7×5cm mass in the left submandibular gland, fixed to the mandible, and no lymph nodes palpable in the neck. The patient had paralysis of the marginal branch of the facial nerve. Fine needle aspiration biopsy (fnab) and CT scan showed a lesion in the left submandibular gland, involving the mandible without apparent bone invasion, and extensive necrotic tissue with infiltration of the floor of the mouth. An incisional biopsy was performed under local anesthesia and histologic sec- tions showed an infiltrative poorly differentiated carcinoma; immunohistochemistry was positive for cytokeratin/ck-6.

Remission Characteristics

While waiting for surgical treatment, the patient presented signs of tumor regression, and after 4 months, the physical signs of the tumor completely disappeared.

Treatment & Mechanisms

Clinical Treatment

Biopsy