Spontaneous Regression In A Primary Adenocarcinoma Of Lung With Epidermal Growth Factor Receptor Mutation
Ahmad, F., Singh, S., & Kumari, N. (2022). Spontaneous regression in a primary adenocarcinoma of lung with epidermal growth factor receptor mutation. Journal of cancer research and therapeutics, 18(6), 1817–1819. https://doi.org/10.4103/jcrt.JCRT_845_20
View Original Source →Abstract
Spontaneous regression (SR) has been reported sporadically in few tumor types. Its occurrence in non-small-cell lung cancer is relatively rare, more so with adenocarcinoma histology. Various mechanisms of SR have been postulated in literature that may play a role in triggering immune response. However, the exact underlying mechanism has yet to be ascertained. We report a rare case of true SR in a primary adenocarcinoma of lung with tumor-infiltrating lymphocytes and epidermal growth factor receptor mutation.
Case Details
Disease Location
Lung, lymph nodes
Personal Characteristics
59‐year‐old male. He was an ex‐chronic smoker, 30 pack‐years of smoking
Clinical Characteristics
Referred after being diagnosed with lung carcinoma. A contrast‐enhanced computed tomography (cect) scan of the thorax revealed a heterogeneously enhancing mass lesion of size 6.6 cm × 3.2 cm in the anterior segment of the upper lobe of the left lung, along with mediastinal lymphadenopathy. Histopathological examination of ct‐guided biopsy from the lung lesion revealed adenocarcinoma with dense tumor‐infiltrating lymphocytes (tils) around the tumor, and egfr mutation analysis by real‐time polymerase chain reaction revealed deletion of exon 19.
Remission Characteristics
Pet‐CT scan about 2 months postbiopsy showed a significant decrease in the size of the primary lung lesion. A repeat cect scan done at 4 months post-biopsy showed a complete resolution of primary and mediastinal nodal disease
Treatment & Mechanisms
Proposed Remission Mechanisms
Stimulation of change in the intra‐tumoral immunological mechanism between the host and the tumor after a direct invasive approach, such as biopsy. Or, induction of antitumor immune response, as there was a dense infiltration of lymphocytes around the tumor on histology.
Clinical Treatment
Biopsy