Case Report


Spontaneous regression of squamous cell carcinoma of the lung with high PD-L1 expression: A case report and literature review

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1 MBBS, Senior House Officer, Department of Radiation Oncology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

2 BSc, MBBS, FRANZCR, Radiation Oncologist, Department of Radiation Oncology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

3 BPharm, MD, FRANZCR, Radiation Oncologist, ICON Cancer Centre Greenslopes, Brisbane, QLD, Australia

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Kelleher Retchford

81 Homebush Rd, Kedron, 4031 QLD,

Australia

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Article ID: 100120Z10KR2023

doi: 10.5348/100120Z10KR2023CR

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How to cite this article

Retchford K, Bettington C, Newman SJ. Spontaneous regression of squamous cell carcinoma of the lung with high PD-L1 expression: A case report and literature review. J Case Rep Images Oncology 2023;9(1):17–21.

ABSTRACT


Introduction: Lung cancer is the leading cause of cancer-related mortality worldwide. Squamous cell carcinomas (SCC) are responsible for a significant proportion of this burden. Spontaneous remission of cancer is a known phenomenon, albeit a rare event. The exact etiological mechanism(s) are not appreciated, although are largely predicated on the complex interactions between the malignant cells, tumor microenvironment and the immune system.

Case Report: We present the case of an incidentally found, biopsy proven lung SCC with high PD-L1 expression that underwent spontaneous regression (SR) prior to definitive therapy. The patient underwent computed tomography (CT)-guided biopsy of the lesion and coronary artery bypass grafting in the time preceding the tumor regression. The observed regression has been sustained during ongoing follow-up.

Conclusion: There are complex interactions between malignant cells, the tumor microenvironment, and the immune system, with evasion of immune destruction being a well-recognized and studied hallmark of cancer. There are multiple factors that may contribute to immune recognition of cancer and its subsequent regression and cases such as this highlight that there is much yet to elucidate. Further identification of these cases and their molecular characteristics will add to our understanding of the process. In the unknown lies the promise of improving cancer outcomes.

Keywords: Non-small cell lung cancer, PD-L1, Spontaneous regression, Squamous cell carcinoma

SUPPORTING INFORMATION


Author Contributions

Kelleher Retchford - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published

Catherine Bettington - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published

St. John Newman - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2023 Kelleher Retchford et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.