Spontaneous regression of pulmonary metastases after nephrectomy for renal cell carcinoma

Spontaneous regression of thoracic malignancies

BACKGROUND

Clinicians are frequently questioned by patients about the possibility of spontaneous regression of tumors. Although there are many reports and a few case series documenting spontaneous regression, there is concern that these cases may not represent true regression. Using specific criteria, we attempted to determine the incidence and types of thoracic malignancy most likely to regress spontaneously.

METHODS

We used a PubMed search of the phrase "spontaneous regression of thoracic lesions" reported from 1951 to December 2008. Using a modified Everson and Cole criterion we developed to define spontaneous regression, this search was refined for true spontaneous regression of primary and metastatic thoracic malignancies.

RESULTS

Only 5 cases in the literature involved spontaneous regression of a primary thoracic malignancy. These include pleural mesothelioma, primary lung cancer and adenoid cystic carcinoma. 71 cases involved true spontaneous regression of metastatic thoracic neoplasms, of which 5 cases showed regression of the primary extrapulmonary tumors along with the pulmonary metastasis. Thoracic metastasis from renal cell carcinoma was the most common malignancy found to regress spontaneously.

CONCLUSION

Spontaneous regression of primary thoracic malignancy is rare. Renal cell carcinoma accounts for most reported cases.

Spontaneous regression of pulmonary and adrenal metastases following percutaneous radiofrequency ablation of a recurrent renal cell carcinoma

The spontaneous regression of metastatic lesions from renal cell carcinoma (RCC) is extremely rare, but may be encountered following cytoreductive treatments. We report a case of a recurrent RCC with multiple metastatic lesions which spontaneously regressed after undergoing radiofrequency ablation of the renal tumor.

Spontaneous regression of metastatic renal cancer. Case report and literature review

A case of spontaneous regression of pleural and intrapulmonary metastases from renal cell cancer is reported with more than 60 cases reported since the original review of this clinical phenomenon in 1964. The metastatic disease sites are most often pulmonary, but extrapulmonary sites include liver, bone, and CNS regressions. The role of nephrectomy in "spontaneous regression" continues to be obscure, accounting for < 50% of documented cases. Immunologic mechanisms, although intellectually attractive, have not been identified.

Expression of aminopeptidase N/CD13 in tumour-infiltrating lymphocytes from human renal cell carcinoma

We have previously demonstrated the expression of aminopeptidase N (APN, CD13) on synovial T cells from patients with different forms of arthritis. T cells of peripheral blood and serous body fluids are CD13-negative but can be stimulated to express CD13 after activation, e.g., with Con A. In the present report, double-labelling and flow cytometry analyses were performed to characterize the phenotype of tumour-infiltrating lymphocytes (TIL). A large panel of antibodies specific for different activation-associated molecules on T cells was used. In contrast to TIL of lung cancer, TIL of renal cell carcinoma (RCC) consisted of significantly higher percentages of T cells expressing CD13, dipeptidylpeptidase N (DPIV, CD26) and HLA-DR, whereas T cells of lung cancer expressed more CD25, CD69 and CD54/ICAM1. No differences could be found in the expression of CD45RO, CD49a/VLA-1 and CD62L/L-selectin. Our results demonstrate that T cells in RCC and lung cancer differ in their phenotype, especially with respect to surface aminopeptidases. Investigations into the function of APN on T cells could be of help in gaining deeper insight into tumour defence as well as into general mechanisms of T cell functions.

Concanavalin A-induced suppressor cell activity in patients with renal cell carcinoma

Concanavalin A (Con A)-induced suppressor cell activity against the proliferative response of autologous lymphocytes to phytohemagglutinin was examined in peripheral blood lymphocytes derived from 12 normal control subjects and 25 patients with renal cell carcinoma (RCC). The Con A-induced suppressor cell activity in patients with RCC (23.4 +/- 21.4%) was significantly higher than that in control subjects (9.7 +/- 10.7%, P less than 0.05). No significant difference between the degree of suppressor cell activity and stage of disease, grade of malignancy, or cell type was found, although the suppressor activity in patients with tumor microscopically infiltrated by lymphocytes was significantly higher than in patients without lymphocyte-infiltration into the tumor (P less than 0.05). Furthermore, compared with control subjects, Con A-induced suppressor activity in patients with high stage and in those with lymphocyte infiltration into the tumor was significantly higher (P less than 0.05 and P less than 0.01, respectively). In conclusion, because patients with RCC have high suppressor cell activity, abrogation of this activity may be necessary to treat the RCC.

Spontaneous regression of pulmonary metastases from renal cell carcinoma

One year after nephrectomy for renal cell carcinoma in a seventy-year-old man pulmonary nodules developed which proved to be metastases by needle biopsy. Chest radiographs thirteen and eighteen months later revealed complete spontaneous regression of the nodules without therapy.

Spontaneous regression of squamous cell lung carcinoma with adrenal metastasis

A 61-year-old man was found to have squamous cell carcinoma of the left hilum with metastasis to the left adrenal gland documented by needle aspiration. About two years later, the primary tumor is not detectable, and the adrenal gland is of normal size on follow-up computerized tomography. To our knowledge, this is the first documented case of spontaneous regression of squamous cell carcinoma of the lung with adrenal metastasis.

Cytotoxic activity of peripheral blood lymphocytes grown with interleukin 2 against autologous cultured tumor cells in patients with renal cell carcinoma: preliminary report

To examine the use of interleukin 2 as a therapeutic agent for human renal cell carcinoma the peripheral blood lymphocytes derived from patients with renal cell carcinoma were grown in interleukin 2 and tested in a 4-hour 51chromium release cytotoxicity assay against autologous cultured tumor cells. Peripheral blood lymphocytes, which were cultured separately in medium alone, mitomycin C-treated tumor cells, 20 per cent interleukin 2 and tumor cells plus interleukin 2, were used as effector cells. In all patients neither peripheral blood lymphocytes in medium alone nor in mitomycin C-treated tumor cells could lyse their own tumor cells. However, in 5 of 7 patients peripheral blood lymphocytes grown in interleukin 2 regardless of the presence of mitomycin C-treated tumor cells were capable of causing 5.7, 9.4, 12.7, 36.1 and 52.5 per cent lysis at effector/target cell ratios of 25, 50, 50, 50 and 25, respectively. However, more significant cytotoxicity was not obtained by peripheral blood lymphocytes cultured with tumor cells and interleukin 2. These results suggest that interleukin 2 might become a useful agent for patients with renal cell carcinoma.