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World J Gastroenterol. Jun 21, 2012; 18(23): 2902-2908
Published online Jun 21, 2012. doi: 10.3748/wjg.v18.i23.2902
Spontaneous regression of pancreatic cancer: Real or a misdiagnosis?
Marta Herreros-Villanueva, Elizabeth Hijona, Angel Cosme, Luis Bujanda
Marta Herreros-Villanueva, Schulze Center for Novel Therapeutics, Division of Oncology Research, Department of Medicine, Mayo Clinic, Rochester, MN 55905, United States
Elizabeth Hijona, Angel Cosme, Luis Bujanda, Department of Gastroenterology, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, University of the Basque Country, Donostia Hospital-Biodonostia Institute, 20014 San Sebastian, Spain
Author contributions: Herreros-Villanueva M and Hijona E designed and wrote the paper; Cosme A and Bujanda L designed and reviewed the paper.
Supported by Instituto Salud Carlos III
Correspondence to: Luis Bujanda, MD, PhD, Department of Gastroenterology, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas, University of the Basque Country, Donostia Hospital-Biodonostia Institute, Paseo Dr. Beguiristain S/N, 20014 San Sebastian, Spain. luis.bujanda@osakidetza.net
Telephone: +34-94-3007173 Fax: +34-94-3007065
Received: January 1, 2012
Revised: March 4, 2012
Accepted: March 20, 2012
Published online: June 21, 2012
Abstract

Spontaneous tumor regression has been subject of numerous studies and speculations for many years. This phenomenon is exceptional, but well reported, in some types of tumors, but not in pancreatic cancer. Pancreatic cancer has the worst five-year survival rate of any cancer. Despite numerous molecular studies and clinical approaches, using several mouse models, this cancer responds poorly to the existing chemotherapeutic agents and progress on treatment remains elusive. Although pancreatic cancer tumors seldom undergo spontaneous regression, and some authors take that with skepticism, there are some cases reported in the literature. However, the variability in the description of the reports and technical details could make this process susceptible to misdiagnosis. Distinguishing between different types of pancreatic carcinoma should be taken with caution as they have wide differences in malignant potential. Diseases such as pancreatic benign tumors, insulinomas, or autoimmune pancreatitis could be responsible for this misdiagnosis as a pancreatic cancer. Here we review different cases reported, their clinical characteristics, and possible mechanisms leading to spontaneous regression of pancreatic cancer. We also discuss the possibilities of misdiagnosis.

Keywords: Autoimmune pancreatitis, Insulinoma, Pancreatic cancer, Pancreatic ductal adenocarcinoma, Spo-ntaneous regression