1
|
Ohara M, Koi Y, Sasada T, Kajitani K, Mizuno S, Takata A, Okamoto A, Nagata I, Sumita M, Imachi K, Watanabe M, Daimaru Y, Kawamura S. Spontaneous regression of breast cancer with immune response: a case report. Surg Case Rep 2021; 7:10. [PMID: 33409705 PMCID: PMC7788137 DOI: 10.1186/s40792-020-01103-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/26/2020] [Indexed: 11/16/2022] Open
Abstract
Background Spontaneous regression (SR) is a rare phenomenon in which a cancer disappears or remits without treatment. We report a case of breast cancer that showed spontaneous tumor regression in the surgical specimen after core needle biopsy. Case presentation A 59-year-old woman came to our hospital complaining of a painful lump in the right breast. In the upper-outer quadrant of the right breast, a tumor with an unclear boundary, 30 mm in diameter, was palpable. In pathological findings from needle biopsy, the tumor was diagnosed as solid-type invasive ductal breast carcinoma. Partial coagulation necrosis was generated in estrogen receptor-negative, HER2-negative, and AE1/AE3-positive ductal carcinoma without infiltration of lymphocytes. Surgery for right breast cancer was then performed. Histological examination of the surgical specimen revealed the tumor was invasive ductal carcinoma with lymphocyte infiltration, coagulation necrosis, and fibrous tissue with hemosiderin. The tumor formed a solid nest, 3 mm in diameter, suggesting the possibility of SR. Conclusions Immune responses, infection, hormones, surgical stress, and ischemia have been reported as mechanisms of SR. The findings in this case strongly suggest that SR of breast cancer is associated with anti-tumor immune responses.
Collapse
Affiliation(s)
- Masahiro Ohara
- Department of Breast Surgery, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan.
| | - Yumiko Koi
- Department of Breast Surgery, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan.,Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Tatsunari Sasada
- Department of Breast Surgery, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Keiko Kajitani
- Department of Breast Surgery, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Seishi Mizuno
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Ai Takata
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Atsuko Okamoto
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Ikuko Nagata
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Mie Sumita
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Kaita Imachi
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Mayumi Watanabe
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Yutaka Daimaru
- Section of Pathological Research and Laboratory, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan
| | - Shingo Kawamura
- Suzumine Imanaka Clinic, 4-2-31, Inokuchi, Nishi-ku, Hatsukaichi, Hiroshima, 733-0842, Japan
| |
Collapse
|
2
|
Katano K, Yoshimitsu Y, Kyuno T, Haba Y, Maeda T, Kitamura S. Temporary spontaneous regression of male breast cancer: a case report. Surg Case Rep 2020; 6:311. [PMID: 33284403 PMCID: PMC7721852 DOI: 10.1186/s40792-020-01088-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Spontaneous regression (SR) of a malignant tumor is the partial or complete disappearance of primary or metastatic tumor tissue in the absence of treatment, which can be temporary or permanent. Here, we report an extremely rare case of male breast cancer that exhibited temporary SR followed by reappearance 8 months after tumor disappearance. Case presentation A 70-year-old man presented at our hospital with a primary complaint of pain and a lump in his left breast. Ultrasonography revealed a hypoechoic lesion measuring 12 mm × 10 mm × 8 mm. Fine-needle aspiration cytology revealed numerous necrotic and degenerated cells and few sheet-like clusters of atypical ductal epithelial cells. The atypical cells had mildly enlarged nuclei with nucleoli, were focally overlapped and formed tubular patterns. The cytological diagnosis indicated a suspicion of malignancy. Core needle biopsy (CNB) revealed necrotic and degenerated cells with microcalcification. The pathological diagnosis was indeterminate because there was no area of viable atypical cells. An excisional biopsy of the left breast lesion was scheduled one month later. However, it was difficult to detect the tumor during physical examination and ultrasonography performed 1 month after the patient’s first visit. The operation was canceled, and the patient received follow-up observation. After 8 months of follow-up, ultrasonography and computed tomography (CT) revealed reappearance of a 0.6-cm-diameter breast tumor in the same place. CNB was performed again and revealed invasive ductal carcinoma. A total mastectomy with sentinel lymph node biopsy was performed 13 months after the first tumor disappeared. Histopathological examination revealed invasive cribriform carcinoma without sentinel lymph node metastasis. The patient did not have any complications, and adjuvant therapy with tamoxifen was started. The patient was alive without recurrence 7 months after surgery. Conclusions Temporary SR followed by tumor reappearance can occur in breast cancer cases, and it is important to follow patients even if their breast tumor has seemingly disappeared. When breast tumors disappear without treatment, clinicians must be aware of the possibility of SR of cancer and should follow the patient for early detection of tumor reappearance.
Collapse
Affiliation(s)
- Kaoru Katano
- Department of Surgery, Houju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan.
| | - Yutaka Yoshimitsu
- Department of Surgery, Houju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan
| | - Takahiro Kyuno
- Department of Surgery, Houju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan
| | - Yusuke Haba
- Department of Surgery, Houju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan
| | - Tsutomu Maeda
- Department of Surgery, Houju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan
| | - Seiko Kitamura
- Department of Pathology, Houju Memorial Hospital, 11-71 Midorigaoka, Nomi, Ishikawa, 923-1226, Japan
| |
Collapse
|