Open Access
CC BY-NC-ND 4.0 · Laryngorhinootologie 2022; 101(S 02): S224-S225
DOI: 10.1055/s-0042-1746624
Poster
Head-Neck-Oncology: Tumor surgery / Functional Reconstructive Surgery

Spontaneous regression of a locally advanced carcinoma of the oral cavity

Authors

  • Jonathan Loeck

    1   Kath. Marienkrankenhaus gGmbH, Klinik für HNO-Heilkunde, Kopf-, Hals- und Plastische Gesichtschirurgie Hamburg

  • Felix Blake

    2   MKG in Reinbek Reinbek

  • Juliana Knief

    3   Kath. Marienkrankenhaus gGmbH, Insitut für Pathologie Hamburg

  • Christoph Thorns

    3   Kath. Marienkrankenhaus gGmbH, Insitut für Pathologie Hamburg

  • Adrian Münscher

    1   Kath. Marienkrankenhaus gGmbH, Klinik für HNO-Heilkunde, Kopf-, Hals- und Plastische Gesichtschirurgie Hamburg

  • Nikolaus Möckelmann

    1   Kath. Marienkrankenhaus gGmbH, Klinik für HNO-Heilkunde, Kopf-, Hals- und Plastische Gesichtschirurgie Hamburg
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    Introduction Spontaneous tumor regression is a rare phenomenon in medicine. It is defined as the complete or partial disappearance of a malignant tumor without treatment or with treatment for which there is as yet no evidence of efficacy (Everson & Cole, 1956).

    Case Report A patient with clinically locally advanced oral cavity carcinoma of the ventral tongue and floor of the mouth had squamous cell carcinoma confirmed histologically. Staging revealed a clinical TNM stage of cT4a cN2b cM0. At the time of biopsy, superinfection of the tumor was present. In addition, local peritonitis was evident after PEG placement. The elevated laboratory parameters of infection regressed under i.v. antibiotics.

    After case discussion in the tumor board and consultation with the patient, subtotal glossectomy with segmental mandibulectomy, MRND on the right and SND level I-IV on the left, tracheostomy, and defect coverage by chimeric scapular graft from the right side were performed 4 weeks after histologic confirmation. Intraoperatively, the tumor was already clinically clearly regressed with nevertheless deeply indurated tongue. Histopathological examination of the resected tissue did not reveal any vital tumor cells. Only a scarring and inflammatory-reactive process was described. The lymph nodes were tumor-free (pN0 (0/83)).

    Discussion The mechanisms of spontaneous tumor regression are not yet known. Possible factors discussed include immunoreactive processes. In the case described by us, both the inital proven infection and the significant improvement of general and nutritional condition due to PEG insertion might have played a role in the spontaneous regression of the tumor.


     

    Conflict of Interest

    The author declares that there is no conflict of interest.

    Publikationsverlauf

    Artikel online veröffentlicht:
    24. Mai 2022

    © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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