Not always a miracle - The case of the missing metastasis

Authors

  • Luís Lourenço Graça Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra – Serviço de Cirurgia Cardiotorácica, Portugal https://orcid.org/0000-0003-3077-1618
  • Sara Lopes Instituto Português de Oncologia do Porto Francisco Gentil – Serviço de Cirurgia Cardiotorácica, Portugal https://orcid.org/0000-0001-9166-9508
  • João Pereira Castro Instituto Português de Oncologia do Porto Francisco Gentil – Serviço de Anatomia Patológica, Portugal
  • Filipe Leite Instituto Português de Oncologia do Porto Francisco Gentil – Serviço de Cirurgia Cardiotorácica, Portugal https://orcid.org/0000-0002-4926-0407
  • Gonçalo Paupério Instituto Português de Oncologia do Porto Francisco Gentil – Serviço de Cirurgia Cardiotorácica, Portugal https://orcid.org/0000-0001-8142-3934

DOI:

https://doi.org/10.48729/pjctvs.451

Keywords:

Spontaneous regression, Renal cell carcinoma, Lung metastasis

Abstract

Spontaneous regression of malignant neoplasms is extremely rare, but renal cell carcinomas (RCC) are most often associated with this phenomenon. We report a case of a patient with personal history of RCC, who underwent nephrectomy and no other oncological treatment. One year after nephrectomy, a lung metastasis was detected and kept under follow-up for 3 years. Its size increased over time until a needle biopsy was performed, and its metastatic nature confirmed. Wedge resection of the lung nodule was performed, and no neoplastic cells were found, suggesting its spontaneous regression after biopsy. Different theories have been proposed to explain this phenomenon and, in most cases, the mechanism seems to involve the activation of the immune system. This case supports the importance of reducing tumor burden and the impact of the disturbance of the tumor microenvironment caused by instrumentation, in improving immune system activation and its essential role in neoplasm regression.

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References

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Published

07-07-2024

How to Cite

1.
Graça LL, Lopes S, Pereira Castro J, Leite F, Paupério G. Not always a miracle - The case of the missing metastasis. Rev Port Cir Cardiotorac Vasc [Internet]. 2024 Jul. 7 [cited 2024 Jul. 18];31(2):55-8. Available from: https://pjctvs.com/index.php/journal/article/view/451

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Section

Clinical Cases

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