Complete and partial spontaneous regression of metastases of lung cancer in a patient: Serial CT and 18F-fluodeoxyglucose PET/CT findings

Shota Tatsumoto, MD, PhD; Yuji Ito, MD, PhD; Tomohiko Yamane, MD, PhD; Hideyuki Nishiofuku, MD, PhD; Ryosuke Taiji, MD, PhD; Takeshi Nagata, MD, PhD; Haruka Ishiguro, MD; Aya Yamada, MD; Toshio Kato, MD, PhD; Toshihiro Tanaka, MD, PhD

Radiology Case Reports (Oct 2024)

Complete and partial spontaneous regression of metastases of lung cancer in a patient: Serial CT and 18F-fluodeoxyglucose PET/CT findings

Shota Tatsumoto, MD, PhD,
Yuji Ito, MD, PhD,
Tomohiko Yamane, MD, PhD,
Hideyuki Nishiofuku, MD, PhD,
Ryosuke Taiji, MD, PhD,
Takeshi Nagata, MD, PhD,
Haruka Ishiguro, MD,
Aya Yamada, MD,
Toshio Kato, MD, PhD,
Toshihiro Tanaka, MD, PhD

Affiliations

Shota Tatsumoto, MD, PhD: Department of Radiology, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya, Aichi 491-8551, Japan; Corresponding author.
Yuji Ito, MD, PhD: Department of Respiratory Medicine, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya, Aichi 491-8551, Japan
Tomohiko Yamane, MD, PhD: Department of Molecular Imaging Research, Kobe City Medical Center General Hospital, 2-1-1, Minatojima-Minamimachi, Chuo-Ku, Kobe 650-0047, Japan
Hideyuki Nishiofuku, MD, PhD: Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
Ryosuke Taiji, MD, PhD: Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
Takeshi Nagata, MD, PhD: Department of Radiology, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya, Aichi 491-8551, Japan
Haruka Ishiguro, MD: Department of Radiology, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya, Aichi 491-8551, Japan
Aya Yamada, MD: Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan
Toshio Kato, MD, PhD: Department of Pathology, Daiyukai General Hospital, 1-9-9 Sakura, Ichinomiya, Aichi 491-8551, Japan
Toshihiro Tanaka, MD, PhD: Department of Diagnostic and Interventional Radiology, Nara Medical University, 840 Shijo-cho, Kashihara 634-8522, Japan

Journal volume & issue: Vol. 19, no. 10
pp. 4403 – 4407

Abstract

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Spontaneous regression of cancer is a rare biological phenomenon and the mechanisms underlying it are poorly understood. There have been few reports of temporal changes in morphology and metabolism associated with spontaneous regression. Here, we report an 80-year-old man who presented with right upper quadrant pain. He was diagnosed with stage IVA lung cancer, but without treatment, rib metastasis disappeared 4 months after the diagnosis. Although mediastinal lymph node metastasis regressed partially it began to grow 10 months after the diagnosis. In this case, complete and partial spontaneous tumor regressions were observed in the patient, allowing for a comparison of morphological and metabolic changes during each occurrence by serial computed tomography (CT) and 18F-fluodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT). We observed that the rib metastasis with high FDG uptake on initial PET/CT was composed of cancer cells as well as intratumoral immune cells, whereas recurrent mediastinal lymph node metastasis with high FDG uptake on follow-up PET/CT was composed of cancer cells with few immune cells. Our findings suggest that hypermetabolism within the rib metastasis on initial PET/CT reflected immune activation, whereas hypermetabolism within the mediastinal lymph node on follow-up PET/CT reflected tumor activation.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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