J Korean Med Sci.  2010 Oct;25(10):1518-1521. 10.3346/jkms.2010.25.10.1518.

A Case of Spontaneous Regression of Advanced Gastric Cancer

• Lee HS
• Cheung DY
• Kim JI
• Cho SH
• Park SH
• Han JY
• Kim JK

• KMID: 2157859
• DOI: http://doi.org/10.3346/jkms.2010.25.10.1518

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.

Keyword

Advanced Gastric Cancer; Neoplasm Regression, Spontaneous

MeSH Terms

Adenocarcinoma/*diagnosis/pathology
Aged, 80 and over
Diabetes Mellitus/drug therapy
Endoscopy, Gastrointestinal
Humans
Hypoglycemic Agents/therapeutic use
Male
Stomach Neoplasms/*diagnosis/pathology
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Initial EGD findings. (A) View of body from gastro-esophageal junction. (B) View of fundus and cardia from distal body. These showed a 10×5 cm sized diffuse edematous and erythematous mucosal change from the cardia just below the gastroesophageal junction to the lower body. EGD, Esophagogastroduodenoscopy.

• 

  Fig. 2 EGD findings after 6 month. (A) View of body from gastro-esophageal junction. (B) View of fundus and cardia from distal body. This showed that normal mucosa was situated from the cardia just below gastro-esophageal junction to the lower body. EGD, Esophagogastroduodenoscopy.

• 

  Fig. 3 Abdominal CT findings. (A) Initial abdominal CT findings. It showed diffuse irregular wall thickening and mucosal enhancement from the cardia to the lower body, perigstric infiltration and no evidence of lymph node enlargement or distant metastasis. (B) Abdominal CT findings after 6 months. It showed wall thickening of a decreased sized area limited to the lesser curvature side and the posterior wall side of the lower body in comparison with 6 months previously. The perigastric infiltration had regressed.

• 

  Fig. 4 Histopathologic findings. (A) The initial histopathologic findings. It showed many malignant cells with nuclear pleomorphism and plump eosinophilic cytoplasm at the lamina propria in the arrows (H&E stain, ×100). (B) The initial histopathologic findings with higher magnification. It also showed many malignant cells with large, irregular nucleus (H&E stain, ×200). (C) Immunohistochemical stain for cytokeratin AE1/AE3. It showed the malignant cells were positive for cytokeratin AE1/AE3 (×200). (D) The histopathologic findings after 6 months. It showed normal findings without any evidence of malignancy (H&E stain, ×40).

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