Synchronous duodenum and descending colon metastasis from primary lung neuroendocrine small-cell carcinoma: A case report and review of the literature

Abstract

Introduction Metastasis to the gastrointestinal tract from lung cancer is very uncommon and is often asymptomatic. Although small bowel metastasis may commonly occur, metastases to the stomach and colon are uncommon. Case report In this paper, we present a previously healthy 57-year-old male patient, a 60-packet per year smoker, who was taken to the emergency room with complaints of increasing abdominal pain, rectal bleeding, weight loss, and dyspnea for the last three months. Endoscopic examination revealed polypoid lesions in the duodenum and the descending colon. We diagnosed neuroendocrine small-cell lung cancer based on histopathological and immunohistochemical staining. Management and outcome: A cisplatin (d1, 60 mg/m2/day)–etoposide (d1 to d3, 120 mg/m2/day) regimen was given every three weeks as palliative chemotherapy. After the three course of chemotherapy, the lung radiograph showed a decline in hilar expansion and there was no pleural effusion. Then, he died of acute respiratory failure two weeks after radiotherapy of brain. Discussion Gastrointestinal tract metastasis of lung cancer is recognized synchronously with or rarely before diagnosis. It is generally recognized after the diagnosis of lung cancer. These patients often have other concurrent body metastases. Prognosis is poor, and survival expectation is short. The most common metastases to the gastrointestinal tract are squamous and large cell lung cancer metastases. Our aim is to emphasize the importance of immunohistochemical examination for masses in the gastrointestinal tract and to present this rare case of synchronous duodenal and colonic metastases of small-cell lung cancer.

Upper gastrointestinal haemorrhage caused by duodenal metastasis from primary lung cancer: A case report

“…In contrast, lung cancer metastasis to the gastrointestinal tract is rare, except oesophagus. 1 The prevalence of small bowel metastases from lung cancer ranges between 2.6% and 10.7%, and most were found incidentally at autopsy examination in patients with advanced or widely disseminated lung cancer. 4 Although any tumour cell type of lung cancer can develop gastrointestinal metastases, the most common type is a squamous cell, followed by a large cell, and then adenocarcinoma.…”

“…The most common sites of metastases were the liver, adrenal gland, bone, and brain. In contrast, lung cancer metastasis to the gastrointestinal tract is rare, except oesophagus 1 . The prevalence of small bowel metastases from lung cancer ranges between 2.6% and 10.7%, and most were found incidentally at autopsy examination in patients with advanced or widely disseminated lung cancer 4 .…”

“…They usually occur in patients with terminal‐stage disease. 1 These metastases are usually asymptomatic but may be revealed by perforation, obstruction, malabsorption, or bleeding. 2 , 3 Bleeding, as the first presentation of duodenal metastases, is rare and related to poor patient survival.…”

“…Duodenal metastases from primary lung carcinoma are uncommon. They usually occur in patients with terminal‐stage disease 1 . These metastases are usually asymptomatic but may be revealed by perforation, obstruction, malabsorption, or bleeding 2,3 .…”

The application of multidisciplinary therapy strategy of precision medicine in tumour diagnosis and treatment

“…2 However, colon metastasis of lung cancer was uncommon. 3 The EGFR L858R mutation was detected by amplification refractory mutation system (ARMS), which was inconsistent with the ctDNA results. The possible reason might be that the collection time of ctDNA was very close to the operation time, which led to low content of ctDNA in blood (circulating free DNA was 11 ng).…”