Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: A case report and literature review

Nozomi Karakuchi, Manabu Shimomura, Kazuhiro Toyota, Takao Hinoi, Hideki Yamamoto, Seiji Sadamoto, Koichi Mandai, Hiroyuki Egi, Hideki Ohdan, Tadateru Takahashi

研究成果査読

11 被引用数 (Scopus)

抄録

Background: Spontaneous regression (SR) of colorectal cancer (CRC) is extremely rare, and only few cases have been reported. Although it is not yet clarified, a plausible mechanism for SR of CRC is an immunological event. Case presentation: In this report, we present the case of SR of primary CRC in a 78-year-old man. Preoperative colonoscopy was performed, and a type 2 tumor measuring 30 mm in diameter in the transverse colon was detected. The biopsy revealed a poorly differentiated adenocarcinoma. Colectomy was performed 2 months after initial colonoscopy. During the surgery, only a 10-mm ulcer harboring a polypoid lesion measuring 8.5 mm was detected in the resected tissue; no other masses or carcinoma cells were seen on histological examination. Afterwards, the biopsy specimens were reanalyzed, and immunohistological analysis verified this as adenocarcinoma with stroma-infiltrating lymphocytes. Further analysis revealed a loss of two mismatch repair proteins, suggesting sporadic high-frequency microsatellite instability (MSI-H). Conclusion: According to previous literature, a common site of SR in CRC is the proximal colon, which is a feature of MSI-H CRC. However, our report showed a rare case of SR of CRC, which was in the transverse colon, with MSI-H present. This report indicates a relationship between immunological features of MSI-H and the occurrence of SR of CRC. A better understanding of this phenomenon and the mechanisms involved will have significant preventive and therapeutic implications for CRC, including anti-PD-1 immune checkpoint inhibitor therapy.

本文言語English
論文番号19
ジャーナルWorld Journal of Surgical Oncology
17
1
DOI
出版ステータスPublished - 1月 15 2019
外部発表はい

ASJC Scopus subject areas

  • 外科
  • 腫瘍学

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