Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5930
Revised: March 4, 2014
Accepted: April 5, 2014
Published online: May 21, 2014
Processing time: 138 Days and 15.3 Hours
Lung cancer is a common malignancy in the world; however symptomatic colonic metastasis from primary lung cancer is rare. A 64-year-old man was originally found poorly differentiated squamous cell carcinoma of right lung and received right lower lobectomy and lymph node dissection. Three years later, the patient presented to our emergency room with the symptom of upper abdominal pain and weight loss. Abdominal palpation and computed tomography scan of the abdomen revealed a large mass measuring 7.6 cm × 8.5 cm in the ascending colon. Colonoscopy and biopsy revealed poorly differentiated squamous cell carcinoma with similar morphological pattern to that of the previous lung cancer. Chemotherapy was given and the patient died 5 mo later. Lung cancer metastatic to the colon confers a poor prognosis: overall survival ranged from 5 wk to 1 year, with a median survival of 3 mo after the diagnosis of the colonic metastasis.
Core tip: Lung cancer with colonic metastasis is a rare condition, accounting for only 0.5% of lung cancer cases. Symptomatic colonic metastases are often emergent and colonoscopy with biopsy can make further diagnosis. Herein we report a case of patient with upper abdominal pain and weight loss after lung cancer resection. Subsequent colonoscopy and pathology confirmed poorly-differrentiated squamous cell carcinoma due to colonic metastasis of lung cancer. The patient improved after receiving chemotherapy but died from rectal bleeding. We report the case for its rarity and emphasize disease management after prompt clinical and pathological analyses.