Case Report
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World J Gastroenterol. May 21, 2014; 20(19): 5930-5934
Published online May 21, 2014. doi: 10.3748/wjg.v20.i19.5930
Colonic metastasis after resection of primary squamous cell carcinoma of the lung: A case report and literature review
Hai-Zhou Lou, Chun-Hua Wang, Hong-Ming Pan, Qin Pan, Jin Wang
Hai-Zhou Lou, Hong-Ming Pan, Qin Pan, Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Chun-Hua Wang, Bachelor of nursing, Department of Admission, Hangzhou Xiasha Hospital, Hangzhou 310000, Zhejiang Province, China
Jin Wang, Department of Pathology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Author contributions: Lou HZ has made substantial contributions to conception and design and was writing the manuscript; Wang CH made substantial contributions to acquisition, analysis and interpretation of the data; Pan HM was revising it critically for important intellectual content and authorized the publication of the article; Pan Q has made substantial contributions to conception and design and has been involved in drafting the manuscript; Wang J provided the pathological data and critically review the manuscript; all authors read and approved the final manuscript.
Supported by Grants from the Program for Innovative Research Team in Zhejiang Province No. 2012R10046 and grants from Administration of Chinese Traditional Medicine of Zhejiang Province No. 2011ZB080
Correspondence to: Hong-Ming Pan, MD, Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, 3 Qingchun Road East, Hangzhou 310000, Zhejiang Province, China. louhz2014@163.com
Telephone: +86-571-86006926 Fax: +86-571-86436673
Received: December 30, 2013
Revised: March 4, 2014
Accepted: April 5, 2014
Published online: May 21, 2014
Processing time: 138 Days and 15.3 Hours
Abstract

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.

Keywords: Lung neoplasm; Colonic metastasis; Squamous cell carcinoma; Chemotherapy

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.