17th INTERNATIONAL MEDICINE AND HEALTH SCIENCES RESEARCHERS CONGRESS
Primary Chest Wall Tumor Spontaneously Shrinking With Intense Inflammatory and Granulomatous Reaction
Introduction:Cancer arises from genetic and epigenetic changes in tumor suppressor genes(TSGs) and proto-oncogenes, with the loss of TSG function being a key driver in cancer development. Primary tumors of the chest wall are rare, originating from various tissues such as bone, muscle, connective tissue, and blood vessels. Thoracic wall metastases are more common than primary tumors. In this case, we present a primary chest wall tumor suppressed by an intense inflammatory reaction. Findings:A 64-year-old male patient presented to our clinic after one year of radiological evaluation and physical therapy for severe shoulder pain. One year later, a CTscan incidentally revealed an invasive lesion in the right 3rd rib. PET-CT showed a solid 18mm lesion in the pleural base of the right upper lung with moderate FDGuptake (SUVmax:7.2), as well as a 25mm nodule in the left adrenal gland with high FDG uptake(SUVmax:9.6). Transthoracic trucut biopsy revealed chronic inflammation and fibrosis. Excision was recommended for diagnostic purposes. Following EUS-guided biopsy, left adrenalectomy confirmed pheochromocytoma. Right thoracotomy, including partial resection of the 3rd rib and wedge resection of the lung, resulted in complete removal of the lesion. Frozen section analysis confirmed a thoracic wall tumor. Pathological examination revealed a 2.5*1.2mm undifferentiated malignant epithelial tumor. The tumor's surrounding tissue showed dense inflammatory cells and granulomatous reaction. However, no pathological staining indicated the primary origin of the tumor. Retrospective evaluation showed spontaneous regression of the tumor from 38*26mm to 25*15mm over one year, suggesting a strong anti-tumor immune response. Conclusion:While studies primarily focus on TSG loss of function, there is limited research on the changes in tumor specimens due to active TSG function. In this case, the tumor's regression and surrounding inflammatory response likely resulted from a strong anti-tumor immune reaction, highlighting the complex role of TSGs in tumor suppression.
