A Case of Spontaneous Regression of Advanced Gastric Cancer

Abstract

An 84 yr-old male with a history of nausea and vomiting for 3 weeks was admitted to our hospital. Esopahgogastroduodenoscopy showed the diffuse infiltrative type of gastric cancer encircling from the cardia to the lower body. On abdominal computerized tomography, the gastric wall was diffusely thickened with overlying mucosal enhancement without lymph node involvement. Histologic examination revealed poorly differentiated adenocarcinoma. So surgical resection was planned. However, patient refused all medical care, and then he was discharged. He lived without any medical support and then he revisited our hospital and showed relieved symptoms on the follow-up exam. On esophagogastroduodenoscopy, the gastric mucosa of the body looked normal without any dysplastic change. Abdominal CT revealed a decreased thickening of the gastric wall of the body. The histology from the endoscopic forceps biopsy showed no evidence of malignancy. The patient is alive without any sign of tumor recurrence after 14 months.

How precision medicine changes medical epistemology: A formative case from Norway

“…In this case, we know that the 5‐year survival rate for this type of cancer without treatment is poor 23 . One case of spontaneous full regression has been reported for this type of cancer, and 19 in gastric cancers worldwide 24 . If these are seen as exceptions, the Board may reason counterfactually that the treatment is the likely difference‐maker in this case.…”

“…However, it is not possible to definitely say that this particular case improved due to the treatment and not some other unknown factor. 24 In sum, the Decision is based on abduction, which is supported by several premises and seemingly also counterfactual reasoning, but this inference does not provide a necessary conclusion.…”

Delayed Spontaneous Regression of Metastatic Gastric Cancer: A Case Report of a Rare Finding

“…Based on GLOBOCAN 2018 data, stomach cancer is the fifth most common neoplasm, with an incidence of 5.7%, and the third most deadly cancer [9]. Our review of the literature revealed that approximately 20 cases of spontaneous gastric cancer regression have been reported so far [4].…”

“…Challis and Stam have established that spontaneous regression of gastric carcinomas is extremely rare [3]. Various pathophysiological mechanisms have been proposed to understand the process of regression, which include immune mediation, tumour inhibition by growth factors and/or cytokines, induction of differentiation, hormonal mediation, elimination of a carcinogen, tumour necrosis and/or angiogenesis inhibition, psychological factors, apoptosis, and epigenetic mechanisms [4,5]. The Everson and Cole study, which reviewed the literature on spontaneous regression of tumours, has described 167 malignancies with spontaneous regression of which four were gastric cancers [6].…”

“…It has been estimated that this occurs in one in 100,000 people with cancer and about 20 such cases have been reported annually [2]. Spontaneous regressions of a malignant tumour have often been reported in hypernephroma, neuroblastoma, malignant melanoma, choriocarcinoma, bladder cancer, but it is extremely rare in stomach cancers [3,4]. In this report, we present a case of spontaneous regression of metastatic gastric cancer in an elderly male patient.…”