Ohara Masahiro, Koi Yumiko, Sasada Tatsunari, Kajitani Keiko, Mizuno Seishi, Takata Ai, Okamoto Atsuko, Nagata Ikuko, Sumita Mie, Imachi Kaita, Watanabe Mayumi, Daimaru Yutaka, Kawamura Shingo
Department of Breast Surgery, Hiroshima General Hospital, 1-3-3 Jigozen, Hatsukaichi, Hiroshima, 738-8503, Japan.
Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
Surg Case Rep. 2021 Jan 6;7(1):10. doi: 10.1186/s40792-020-01103-5.
Spontaneous regression (SR) is a rare phenomenon in which a cancer disappears or remits without treatment. We report a case of breast cancer that showed spontaneous tumor regression in the surgical specimen after core needle biopsy.
A 59-year-old woman came to our hospital complaining of a painful lump in the right breast. In the upper-outer quadrant of the right breast, a tumor with an unclear boundary, 30 mm in diameter, was palpable. In pathological findings from needle biopsy, the tumor was diagnosed as solid-type invasive ductal breast carcinoma. Partial coagulation necrosis was generated in estrogen receptor-negative, HER2-negative, and AE1/AE3-positive ductal carcinoma without infiltration of lymphocytes. Surgery for right breast cancer was then performed. Histological examination of the surgical specimen revealed the tumor was invasive ductal carcinoma with lymphocyte infiltration, coagulation necrosis, and fibrous tissue with hemosiderin. The tumor formed a solid nest, 3 mm in diameter, suggesting the possibility of SR.
Immune responses, infection, hormones, surgical stress, and ischemia have been reported as mechanisms of SR. The findings in this case strongly suggest that SR of breast cancer is associated with anti-tumor immune responses.
自发消退（SR）是一种罕见现象，即癌症未经治疗而消失或缓解。我们报告一例乳腺癌病例，该病例在粗针活检后的手术标本中出现了肿瘤自发消退。
一名59岁女性因右乳疼痛性肿块前来我院就诊。在右乳外上象限可触及一个边界不清、直径30毫米的肿瘤。针吸活检的病理结果显示，该肿瘤被诊断为实性型浸润性导管癌。在雌激素受体阴性、人表皮生长因子受体2（HER2）阴性且AE1/AE3阳性的导管癌中出现了部分凝固性坏死，无淋巴细胞浸润。随后对该患者实施了右乳腺癌手术。手术标本的组织学检查显示，肿瘤为浸润性导管癌，伴有淋巴细胞浸润、凝固性坏死以及含铁血黄素的纤维组织。肿瘤形成了一个直径3毫米的实性巢，提示存在自发消退的可能性。
免疫反应、感染、激素、手术应激和缺血已被报道为自发消退的机制。该病例的研究结果强烈表明，乳腺癌的自发消退与抗肿瘤免疫反应有关。
