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Tao J, Wu Z, Huang R, Li J, Xu T, Gao Y, Jia W, Chen H. Primary Lung Squamous Cell Carcinoma With Intestinal Metastasis: A Case Report and Literature Review. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13817. [PMID: 39118303 PMCID: PMC11310267 DOI: 10.1111/crj.13817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 07/16/2024] [Accepted: 07/19/2024] [Indexed: 08/10/2024]
Abstract
Lung squamous cell carcinoma (LUSC) is characterized by a high rate of metastasis and recurrence, leading to a poor prognosis for affected patients. Intestinal metastasis of LUSC is a rare clinical occurrence. Treatment options for LUSC patients with intestinal metastasis are limited, and no standard therapy guidelines exist for managing these cases. In this review, we discuss the clinical features, diagnosis, and treatment of LUSC patients with intestinal metastasis and present a rare case of LUSC with intestinal metastasis. We describe a patient who presented with a severe cough and chest pain and diagnosed with LUSC and bone tumor. Initially, the primary LUSC and bone tumor were controlled with standard treatments. However, the primary LUSC reoccurred shortly after treatment, this time with intestinal metastasis, for which effective treatments are lacking. Our observation from the case suggests that LUSC metastasizing to intestinal tract is associated with a poorer prognosis.
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Affiliation(s)
- Jin Tao
- Department of Cardiothoracic SurgerySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Zhiqiang Wu
- Department of Cardiothoracic SurgerySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Rongfei Huang
- Department of PathologySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Jun Li
- Department of GastroenterologySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Tiewei Xu
- Department of Cardiothoracic SurgerySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Yujie Gao
- Department of StomatologySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Weikun Jia
- Department of Cardiothoracic SurgerySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
| | - Hu Chen
- Department of Cardiothoracic SurgerySchool of Clinical Medicine and The First Affiliated Hospital of Chengdu Medical CollegeChengduChina
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Lin ZX, Weiss A, Lee KI, Heering G, Chang L, Pais S. Metastatic Squamous Cell Carcinoma of the Lung Disclosed From Constipation Workup. ACG Case Rep J 2023; 10:e01133. [PMID: 37654618 PMCID: PMC10468112 DOI: 10.14309/crj.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
A palpable rectal mass associated with gastrointestinal (GI) symptoms immediately raises concern for colorectal cancer, but rarely can represent distant metastatic disease. The incidence of symptomatic colorectal metastasis from a primary lung cancer without any pulmonary symptom is extremely rare. We report a rare case of constipation as the presenting symptom in a patient ultimately found to have metastatic squamous cell carcinoma of the lung. A rectal mass was readily palpable on examination, illustrating the importance of digital rectal examination. In addition, GI clinicians should maintain a high index of suspicion when evaluating patients at risk of non-GI malignancies.
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Affiliation(s)
- Zilan X. Lin
- Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, Valhalla, NY
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Aaron Weiss
- Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, Valhalla, NY
| | - Kyu-In Lee
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Gabriel Heering
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Lillian Chang
- Department of Medicine, Westchester Medical Center, Valhalla, NY
| | - Shireen Pais
- Division of Gastroenterology and Hepatobiliary Diseases, Westchester Medical Center, Valhalla, NY
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3
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Nakayama Y, Yamaguchi M, Inoue K, Hamaguchi S, Tajima Y. Successful resection of colonic metastasis of lung cancer after colonic stent placement: A case report and review of the literature. World J Gastrointest Surg 2023; 15:1549-1558. [PMID: 37555118 PMCID: PMC10405118 DOI: 10.4240/wjgs.v15.i7.1549] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Lung cancer is the leading cause of cancer deaths worldwide. Although lung cancer can metastasize to various organs such as the liver, lymph nodes, adrenal gland, bone, and brain, metastases to the digestive organs, especially the colon, are rare. CASE SUMMARY An 83-year-old man diagnosed with lung cancer received radiation and chemoimmunotherapy, resulting in a complete clinical response. One year after the initial lung cancer diagnosis, the patient presented with obstructive ileus caused by a tumor in the descending colon. An elective left hemicolectomy was successfully performed after the endoscopic placement of a self-expandable metallic stent (SEMS). Pathologically, the tumor of the descending colon was diagnosed as lung cancer metastasis. The postoperative course was uneventful, and the patient is in good condition 13 mo after surgery, with no signs of recurrence. The previous 23 cases of surgical resection of colonic metastasis from lung cancer were reviewed using PubMed to characterize their clinicopathological features and outcomes. CONCLUSION SEMS is useful for obstructive colonic metastasis as a bridge to surgery to avoid emergency operations.
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Affiliation(s)
- Yoko Nakayama
- Department of Surgery, Oda Municipal Hospital, Oda 694-0063, Shimane, Japan
| | - Minekazu Yamaguchi
- Department of General Medicine, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
| | - Keisuke Inoue
- Department of Surgery, Oda Municipal Hospital, Oda 694-0063, Shimane, Japan
| | - Shunichi Hamaguchi
- Department of General Medicine, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan
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Parker NA, McBride C, Forge J, Lalich D. Bowel obstruction caused by colonic metastasis of lung adenocarcinoma: a case report and literature review. World J Surg Oncol 2019; 17:63. [PMID: 30961608 PMCID: PMC6454752 DOI: 10.1186/s12957-019-1611-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/29/2019] [Indexed: 01/07/2023] Open
Abstract
Introduction Lung cancer is the most common cause of cancer-related deaths globally. Metastatic disease is often found at the time of initial diagnosis in the majority of lung cancer patients. However, colonic metastases are rare. This report describes an uncommon case of colonic metastasis from lung adenocarcinoma. Case presentation A 64-year-old female presented to her gastroenterologist for progressively worsening abdominal pain and constipation. Exploratory colonoscopy revealed a large rectosigmoid mass resulting in near total rectal occlusion. Her specialist recommended she immediately go to her regional hospital for further workup. On admission, she complained of continued abdominal pain and constipation. Notably, she had a past medical history of non-small cell lung cancer (T1bN3M0 stage IIIB), diagnosed 1 year prior. She was thought to be in remission following radiation and immunotherapy with pembrolizumab. Upon hospital admission, she underwent an urgent colostomy, ileocecectomy and anastomosis, and rectosigmoid mass resection with tissue sampling. Pathology confirmed the diagnosis of colonic metastasis from primary lung adenocarcinoma. Treatment was with systemic chemotherapy followed by localized radiation to the pelvic region was started. She did not respond well to these therapies. Subsequent imaging showed refractory tumor growth in the pelvic region. Treatment could not be completed due to the patient experiencing a debilitating stroke, and she was transitioned to hospice care. Conclusions Clinicians should have a low threshold for intestinal investigation and considerations for colonic metastasis when patients with a history of primary lung cancer have abdominal symptoms.
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Affiliation(s)
- N A Parker
- Department of Internal Medicine, University of Kansas School of Medicine, 2817 N Tallgrass St, Wichita, KS, 67226, USA.
| | - C McBride
- Department of Internal Medicine, University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - J Forge
- Department of Internal Medicine, University of Kansas School of Medicine, 1010 N Kansas St, Wichita, KS, 67214, USA
| | - D Lalich
- Department of Anatomical and Clinical Pathology, Wesley Medical Center, 550 N. Hillside St, Wichita, KS, 67214, USA
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Balla A, Subiela JD, Bollo J, Martínez C, Rodriguez Luppi C, Hernández P, Pascual-González Y, Quaresima S, Targarona EM. Gastrointestinal metastasis from primary lung cancer. Case series and systematic literature review. Cir Esp 2018; 96:184-197. [PMID: 29567360 DOI: 10.1016/j.ciresp.2017.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 11/14/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023]
Abstract
Aim of the present study is to report clinical characteristics and outcomes of patients treated in authors' hospital for GI metastasis from primary lung cancer, and to report and analyse the same data concerning patients retrieved from a systematic literature review. We performed a retrospective analysis of prospectively collected data, and a systematic review using the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Ninety-one patients were included, 5 patients from the authors' hospital and 86 through PubMed database using the keywords "intestinal metastasis" AND "lung cancer". The median time between primary lung cancer diagnosis and GI metastasis diagnosis was 2 months and the median overall survival was 4 months. This group of patients present a poor prognosis and the gold standard treatment is not defined. None of the reported treatments had a significant impact on survival.
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Affiliation(s)
- Andrea Balla
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España; Department of General Surgery and Surgical Specialties Paride Stefanini, Sapienza, University of Rome, Roma, Italia.
| | - José D Subiela
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Jesús Bollo
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Carmen Martínez
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Carlos Rodriguez Luppi
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Pilar Hernández
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
| | - Yuliana Pascual-González
- Servicio de Neumología, Hospital Universitario de Bellvitge, Universidad de Barcelona, Barcelona, España
| | - Silvia Quaresima
- Department of General Surgery and Surgical Specialties Paride Stefanini, Sapienza, University of Rome, Roma, Italia
| | - Eduard M Targarona
- Unidad de Cirugía General y Digestiva, Hospital de la Santa Creu y Sant Pau, Universidad Autónoma de Barcelona, Barcelona, España
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6
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Browne I, Panayides P, Valji A. Metastatic squamous cell cancer of the lung presenting as a perforated cecal cancer. J Surg Case Rep 2018; 2018:rjx262. [PMID: 29383242 PMCID: PMC5786217 DOI: 10.1093/jscr/rjx262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/05/2018] [Indexed: 12/04/2022] Open
Abstract
Lung cancer is the leading cause of cancer deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for 85% of diagnoses. Metastasis occurs in ~50% of cases but clinically evident isolated gastrointestinal (GI) metastasis is rare. We present a 78-year-old female who underwent an urgent right hemi-colectomy after cross-sectional imaging revealed a perforated cecal mass. Final pathology demonstrated squamous cell cancer of lung origin. We review the literature on NSCLC with clinically evident metastases to the GI tract, as well as important diagnostic considerations.
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Affiliation(s)
- Ikennah Browne
- Department of General Surgery, University of Calgary, Calgary, Alberta, CanadaT2N 2T9
| | - Pete Panayides
- Department of General Surgery, Red Deer Regional Hospital, University of Alberta, Edmonton, Alberta, CanadaT4N 4E6
| | - Azim Valji
- Department of Thoracic Surgery, University of Alberta, Edmonton, Alberta, CanadaT6G 2B7
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7
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Colonic Metastasis From Esophageal Squamous Cell Carcinoma Demonstrated With 18F-FDG PET/CT. Clin Nucl Med 2017; 42:456-457. [PMID: 28368888 DOI: 10.1097/rlu.0000000000001656] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Metastatic involvement of the colon is extremely rare. We report a 63-year-old man with colonic metastasis from esophageal squamous cell carcinoma. Whole-body F-FDG PET/CT showed abnormal tracer uptakes in the sigmoid colon, which was subsequently confirmed as metastatic from esophageal squamous cell carcinoma.
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8
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Asayama N, Oka S, Tanaka S, Hirano D, Sumimoto K, Ninomiya Y, Tamaru Y, Shigita K, Hayashi N, Shimamoto F, Arihiro K, Chayama K. Pedunculated-type T1 colorectal carcinoma with lung carcinoma metastasis at the deepest invasive portion. Clin J Gastroenterol 2016; 9:208-14. [PMID: 27259703 DOI: 10.1007/s12328-016-0659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/24/2016] [Indexed: 11/30/2022]
Abstract
We present a rare case of colorectal T1 carcinoma with metastasis of previous lung carcinoma found at the deepest invasive portion. A 61-year-old man presented with cervical lymphadenopathy 18 years after undergoing surgery for right lung carcinoma [poorly differentiated adenocarcinoma stage IIb (T3N0M0)]. Contrast-enhanced computed tomography showed enlarged lymph nodes (LNs) in the neck and mediastinal regions. Combined hybrid-F-fluorodeoxyglucose positron emission-computerized tomography showed increased radionuclide uptake in multiple cervical LNs and mediastinal LNs. LN biopsy revealed a poorly differentiated adenocarcinoma, suspected to be a metastatic tumor of the lung. Subsequent colonoscopy revealed a pedunculated-type lesion with a depressed area in the ascending colon. We performed polypectomy as total excisional biopsy; this tumor was composed mainly of moderately differentiated adenocarcinoma, partially mixed with mucinous adenocarcinoma. The pathological findings of the invasive front of the colorectal carcinoma showed poorly differentiated adenocarcinoma with a morphological pattern similar to that of the previous lung carcinoma. Furthermore, immunohistochemical results for the histological type of the deepest invasive portion of the tissue specimen were positive for thyroid transcription factor-1 but negative for Caudal-type homeobox 2. From these morphological and immunohistochemical findings, the final diagnosis was moderately differentiated lung carcinoma, pTX N3 M1b (LN, colon) Stage IV.
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Affiliation(s)
- Naoki Asayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Shiro Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Daiki Hirano
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kyoku Sumimoto
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Ninomiya
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuzuru Tamaru
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenjiro Shigita
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nana Hayashi
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Fumio Shimamoto
- Department of Health Science, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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9
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Chen CH, Chen WM, Tung SY, Wu CS, Tong WL, Lee KF, Wei KL. Gastrointestinal metastasis from primary sarcomatoid carcinoma of the lung: a case report and review of the literature. World J Surg Oncol 2015; 13:174. [PMID: 25947890 PMCID: PMC4440284 DOI: 10.1186/s12957-015-0599-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 04/28/2015] [Indexed: 12/30/2022] Open
Abstract
Gastrointestinal metastases in lung cancer are extremely rare. The report presents a rare case of primary lung sarcomatoid carcinoma with both gastric and colonic metastases, and reviews the literature about endoscopic presentation of colonic metastases.
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Affiliation(s)
- Chun-Hsien Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan. .,Current address: Chun-Hsien Chen, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan.
| | - Wei-Ming Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan. .,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Shui-Yi Tung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Cheng-Shyong Wu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Wei-Lin Tong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan.
| | - Kam-Fai Lee
- Department of Anatomic Pathology, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan.
| | - Kuo-Liang Wei
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, 6 Section West, Chia-Po Road, Putz City, Chia-Yi, 613, Taiwan. .,College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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10
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Lou HZ, Wang CH, Pan HM, Pan Q, Wang J. Colonic metastasis after resection of primary squamous cell carcinoma of the lung: A case report and literature review. World J Gastroenterol 2014; 20:5930-5934. [PMID: 24914356 PMCID: PMC4024805 DOI: 10.3748/wjg.v20.i19.5930] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 04/09/2014] [Indexed: 02/07/2023] Open
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.
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11
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Gonzalez-Tallon AI, Vasquez-Guerrero J, Garcia-Mayor MA. Colonic Metastases From Lung Carcinoma: A Case Report and Review of the Literature. Gastroenterology Res 2013; 6:29-33. [PMID: 27785223 PMCID: PMC5051117 DOI: 10.4021/gr518e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 12/18/2022] Open
Abstract
Lung cancer is the most frequent cause of cancer death in the world. Although about 50% of lung cancers have distant metastases at the time of diagnosis, gastrointestinal metastasis has rarely been described. The most common metastatic site is the small bowel, whereas, colonic metastases are very rare. This report presents a clinical case of a 68-year-old male with a previous diagnosis of non-microcytic lung carcinoma (T4, N2, M1), stage IV, who presented rectorrhagia at the emergency. Colonoscopy showed many ulcerated tumors along the colon and histology proved that these lesions were metastases of primitive lung carcinoma. Gut metastasis from the lung is uncommon but we have to be aware of it in patients who present gastrointestinal symptoms.
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12
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Baber J, Diedrich W, Agrawal S. Synchronous colonic masses as initial presentation of metastatic lung cancer. J Gastrointest Cancer 2013; 44:460-2. [PMID: 23325396 DOI: 10.1007/s12029-012-9462-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Joseph Baber
- Dayton VA Medical Center, Wright State University-Boonshoft School of Medicine, Dayton, OH, USA,
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13
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Intestinal obstruction caused by colonic metastasis from intrahepatic cholangiocarcinoma 6 years after removal of the primary tumor: report of a case. Surg Today 2012; 42:797-800. [PMID: 22307905 DOI: 10.1007/s00595-012-0138-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 07/15/2011] [Indexed: 12/19/2022]
Abstract
We report a case of intestinal obstruction caused by metastasis that manifested 6 years after surgery for intrahepatic cholangiocarcinoma (ICC). The patient, a 57-year-old man, had undergone resection of the hepatic left lobe, Spiegel lobe, and extrahepatic bile duct, following which histopathological examination had confirmed the diagnosis of ICC and that the resection margins were free from disease. There had been no signs of recurrence until an increase in the CA19-9 level was detected 6 years later. Colonoscopy revealed an ulcer-like lesion and stenosis at the level of the hepatic flexure. The patient was subsequently admitted to our hospital with abdominal pain and underwent right hemicolectomy with partial resection of hepatic segment V. Based on the immunohistological finding that the expression pattern of cytokeratins and mucins was consistent with ICC origin rather than colon cancer origin, we diagnosed colon metastasis from ICC.
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14
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Lung Adenocarcinoma Staged as an Unknown Primary Presenting with Symptomatic Colon Metastases: Staging by 18F-FDG PET/CT. Nucl Med Mol Imaging 2011; 45:314-8. [PMID: 24900023 DOI: 10.1007/s13139-011-0096-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 06/29/2011] [Indexed: 10/18/2022] Open
Abstract
A 66-year-old man, who presented with bright red blood per rectum, was referred for an (18)F-FDG PET/CT after colonoscopy showed two suspicious colon masses, which were biopsied to reveal an adenocarcinoma of unknown origin. PET/CT showed two intensely FDG-avid colon masses as well as an unsuspected FDG-avid lung mass, which was biopsied to reveal a primary lung adenocarcinoma. Immunohistochemistry confirmed the two colon metastases were of pulmonary origin. It is extremely rare for lung carcinoma to present with symptomatic colon metastases, with only 11 cases described in the literature. We report the first case of the utility of (18)F-FDG PET/CT in staging a patient who presented with symptomatic colon metastases of an unknown primary lung malignancy.
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15
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Intestinal Metastasis of a Primary Lung Carcinoma Presenting as Mechanical Small Bowel Obstruction. J Gastrointest Cancer 2011; 43 Suppl 1:S13-5. [DOI: 10.1007/s12029-011-9297-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Colonic metastasis from primary lung adenocarcinoma: case report and review of the literature. Med Oncol 2011; 29:644-7. [PMID: 21516483 DOI: 10.1007/s12032-011-9954-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 04/08/2011] [Indexed: 12/13/2022]
Abstract
We report a rare case of a 38-year-old woman with metastatic colonic adenocarcinoma from primary lung adenocarcinoma detected by PET/CT. She underwent colonoscopy and adenocarcinoma was diagnosed in the pathology report, which was the same as that for lymph node biopsy from a left supraclavicular lymph node. We used immunohistochemistry to diagnose primary adenocarcinoma of the lung with colonic metastasis. Owing to mutation in exon 19 of EGFR gene, targeted therapy was given to her with a prescription of oral gefitinib for 1 month as first-line treatment. It was chosen to further treat the patient with chemotherapy and radiotherapy. As the patient was suffering from increasing coughing and sputum, radiotherapy and chemotherapy were subsequently cancelled. Since the general condition of the patient was relatively poor, Tarceva was therefore prescribed. The patient had lived for 5 more months since the diagnosis of metastatic colonic adenocarcinoma.
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