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Spontaneous Complete Regression Of A Rectal Cancer.

Sakamoto, S. 2009Colorectal cancer

Sakamoto, S., Fu, K., Kobayashi, O., Matsuyama, S., Miyazaki, A., Ogura, K., & Watanabe, S. (2009). spontaneous complete regression of a rectal cancer. Endoscopy, 41(10), 910–912. https://doi.org/10.1055/s-0029-1215046

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Abstract

We report a unique case of a biopsy-proven rectal cancer exhibiting spontaneous complete regression in an extremely short period of 3 months. An 80-year-old man visited our hospital because of a positive fecal occult blood test. Colonoscopy showed a sessile polyp, about 25 mm in diameter, in the middle part of the rectum. Instead of endoscopic resection, two endoscopic biopsies were taken for histological evaluation, as an invasive cancer was endoscopically suspected.Well-differentiated invasive adenocarcinoma was revealed, and thus surgical resection was planned. At the second colonoscopy for endoscopic tattooing before surgery, the polyp was found to have unexpectedly developed into a flat lesion. Furthermore, the surgically removed specimen showed that the flat lesion had transformed to a depressed lesion, and surprisingly, no cancerous tissue was detected histologically.

Case Details

Disease Location

Colon

Personal Characteristics

80-year-old man

Clinical Characteristics

Positive fecal occult blood test. Colonoscopy showed three pedunculated polyps about 8 – 10 mm in size, in the ascending colon, descending colon, and sigmoid colon. All three polyps were removed with snare polypectomy, and all were found to be benign adenomas histologically. Additionally, a sessile polyp 25mm in size, was detected in the middle part of the rectum. Endoscopically, an invasive carcinoma was suggested, because of the large size and because the surface was irregular, friable, and erosive.two endoscopic biopsies were taken for histological evaluation. This showed well-differentiated invasive tubular adenocarcinoma, and thus surgical resection was planned. Thereafter, a low anterior resection was conducted for treatment. Surprisingly, the flat lesion had transformed to a depressed lesion

Remission Characteristics

Before surgery, the polyp had developed into a flat lesion. No cancerous tissue was found, only infiltration of inflammatory cells and scar tissue

Treatment & Mechanisms

Proposed Remission Mechanisms

Immune-mediated host responses

Clinical Treatment

Polypectomy anterior resection