Two patients with non-regional metastases of adenocarcinoma of the lung 11 and 14 years following surgery

Abstract Two patients are described who developed non-regional metastases of adenocarcinoma of the lung at 11, and 14 years following resection of the primary tumor. In each case a careful search failed to reveal a second primary lung tumor. The metastases were discovered in brain and a supraclavicular lymph node. Such distant metastases arising more than 10 years after primary surgery is a very rare event in adenocarcinoma of the lung. These patients were part of a small group who had received adjuvant immunochemotherapy following curative surgery. They developed moderate to very strong delayed hypersensitivity reactions to soluble tumor antigens that persisted from 10 to more than 14 years. The clinical course of these patients share many features with the conditions needed for the induction, maintenance and abrogation of tumor dormancy in animal models.