Small Bowel Perforation Secondary to Metastatic Lung Cancer: A Case Report with Literature Review

Abstract

Lung cancer is usually diagnosed at an advanced stage, and metastases are present in 40% of patients. The preferential sites of extrapulmonary spread include lymph nodes, liver, brain, adrenal gland, and bone. Small bowel metastasis of lung cancer is a very rare occurrence and may be clinically missed due to the unspecificity of the symptoms. The prognosis is poor. Screening the bowel for metastatic disease cannot be recommended because of its low incidence. However, if a patient with lung cancer presents with gastrointestinal complaints, bowel enema and CT are helpful in diagnosis. Early diagnosis and surgical intervention leads to better palliation and short-term survival.

A Rare Cause of Small Bowel Transection: Metastatic Lung Cancer

“…In our case, macroscopic disease was not found either at the site of perfora- tion or in any other area of the abdomen. Local recurrence is seen more frequently in patients with squamous cell carcinoma, as in our case; patients with adenocarcinoma more often have distant metastases [6] .…”

Small bowel perforation and death caused by anaplastic thyroid carcinoma metastasis in a patient with concomitant colonic and bilateral breast carcinoma.

“…49,50 Rare cases of testicular seminoma, 51 osteosarcoma, 52,53 and Ewing sarcoma 54 have also been described. Symptoms of intestinal metastasis described in the literature include intussusception, 16,[20][21][22][23][24][25][26][27][28][29][43][44][45][46][47][48][49][50][51][52][53][54] and perforation [17][18][19][30][31][32][33][34][35][36][37][38][39][40][41][42] . The curative treatment of ATC is multimodal and consists of surgery and external beam radiation therapy with radio-sensitizing chemotherapy.…”

Testicular Choriocarcinoma with Jejunal Metastasis Complicated by Intestinal Perforation and Acute Peritonitis

“…Among extra-abdominal primaries, small bowel metastases have been described most frequently in non-small cell carcinoma of the lung and malignant melanoma [7], and may be complicated by intestinal obstruction, gastrointestinal bleeding, intussusception, or perforation. Gastrointestinal perforation secondary to the metastasis of the small intestine has been documented in patients with lung carcinoma as well as other primary tumors [14][15][16]. Early diagnosis and emergency surgical intervention are essential.…”