Lung Cancer: Adenocarcinoma of the Lung with Metastasis of Neck, Ribs, and Humerus
Adenocarcinoma of the Lung with Metastasis of Neck, Ribs, and Humerus
Caucasian female age 88 years, presented 12/12/84 with a 4 cm right upper lobe mass. Needle biopsy was interpreted as poorly differentiated adenocarcinoma. Radical radiotherapy (7000 cGy) was delivered to the primary cancer. Two months later radiotherapy was delivered to apparent painful metastatic sites in the right proximal humerus and left rib cage and to a diffuse mass expanding the right neck. Two months later the same areas were retreated. Four months later the right neck was treated for the third time. Due to the patient’s age and early senility, chemotherapy was never recommended.
Concurrent with the initial radiotherapy, vitamin E 1000 IU, bromocriptine 1.25 IU twice daily, and medroxyprogesterone acetate10 mg twice daily were begun. Use of these medications by the patient was sustained after radiotherapy, except for the vitamin E.
After an unanticipated remission in new bone or soft tissue manifestations lasting more than two years, a lymphocyte subset analysis was obtained. This study revealed the NK surface markers, Leu 7 to be 60.2% and Leu 11 = 69.6%, by far the highest level ever seen before or after at the Clinical Immunopathology Laboratory at the University of Mississippi Medical Center. Death of senile brain disease, sepsis, and dehydration occurred one year after documentation during remission of extraordinary NK%.
Until her death from pneumonia 3 years after radiotherapy, the patient manifested a large diffuse soft tissue mass in the base of the right neck over the previously irradiated apparent supraclavicular recurrence. She continued cimetidine 300 mg four times daily and medroxyprogesterone acetate 10 mg twice daily and did not experience a second relapse. No serologic markers were employed.
Authors comments: Arrest of metastatic progression of disseminated lung cancer with evidence of extraordinary NK% elevation to more than four times the upper limit of normal supports the hypothesis of efficacious NK based sinecommitant immunity.