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Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review
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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334436/ https://www.ncbi.nlm.nih.gov/pubmed/30646898 http://dx.doi.org/10.1186/s12957-018-1552-x |
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author | Karakuchi, Nozomi Shimomura, Manabu Toyota, Kazuhiro Hinoi, Takao Yamamoto, Hideki Sadamoto, Seiji Mandai, Koichi Egi, Hiroyuki Ohdan, Hideki Takahashi, Tadateru |
author_facet | Karakuchi, Nozomi Shimomura, Manabu Toyota, Kazuhiro Hinoi, Takao Yamamoto, Hideki Sadamoto, Seiji Mandai, Koichi Egi, Hiroyuki Ohdan, Hideki Takahashi, Tadateru |
author_sort | Karakuchi, Nozomi |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6334436 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63344362019-01-23 Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review Karakuchi, Nozomi Shimomura, Manabu Toyota, Kazuhiro Hinoi, Takao Yamamoto, Hideki Sadamoto, Seiji Mandai, Koichi Egi, Hiroyuki Ohdan, Hideki Takahashi, Tadateru World J Surg Oncol Case Report 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. BioMed Central 2019-01-15 /pmc/articles/PMC6334436/ /pubmed/30646898 http://dx.doi.org/10.1186/s12957-018-1552-x Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Karakuchi, Nozomi Shimomura, Manabu Toyota, Kazuhiro Hinoi, Takao Yamamoto, Hideki Sadamoto, Seiji Mandai, Koichi Egi, Hiroyuki Ohdan, Hideki Takahashi, Tadateru Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
title | Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
title_full | Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
title_fullStr | Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
title_full_unstemmed | Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
title_short | Spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
title_sort | spontaneous regression of transverse colon cancer with high-frequency microsatellite instability: a case report and literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334436/ https://www.ncbi.nlm.nih.gov/pubmed/30646898 http://dx.doi.org/10.1186/s12957-018-1552-x |
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