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Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report

RATIONALE: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. PATIENT CONCERNS: Clinical data and treatment of a 59-yea...

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Autores principales: Ying, Xiaofang, Wang, Mingwei, Verma, Vivek, Wang, Manxiang, Ye, Shengwei, Bi, Jianping, Zhou, Xiaoyi, Han, Guang, Zhen, Weining
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572002/
https://www.ncbi.nlm.nih.gov/pubmed/28834880
http://dx.doi.org/10.1097/MD.0000000000007768
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author Ying, Xiaofang
Wang, Mingwei
Verma, Vivek
Wang, Manxiang
Ye, Shengwei
Bi, Jianping
Zhou, Xiaoyi
Han, Guang
Zhen, Weining
author_facet Ying, Xiaofang
Wang, Mingwei
Verma, Vivek
Wang, Manxiang
Ye, Shengwei
Bi, Jianping
Zhou, Xiaoyi
Han, Guang
Zhen, Weining
author_sort Ying, Xiaofang
collection PubMed
description RATIONALE: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. PATIENT CONCERNS: Clinical data and treatment of a 59-year-old man with small intestine metastasis from primary solid subtype lung adenocarcinoma are summarized. DIAGNOSES: A man who was previously diagnosed with stage IIIA (T3N2M0) lung adenocarcinoma (solid subtype) came to our hospital for postoperative radiotherapy. Laboratory tests indicated anemia and melena. The patient was initially believed to have digestive ulcer and was treated with omeprazole, which proved to be ineffective. We conducted an abdominal computed tomography (CT) contrast scan and discovered a mass in the small intestine mass. Further positron emission tomography–computed tomography (PET-CT) imaging indicated the small intestine mass with fluorodeoxyglucose uptake. INTERVENTIONS: The patient underwent an enterectomy and anastomosis. Pathological analysis confirmed the diagnosis of small intestinal metastasis from lung cancer with concomitant mesenteric lymph node metastasis. OUTCOMES: One month after the operation, hemoglobin levels became normal, and the patient had good quality of life. However, 3 months after the operation, the patient suffered from anemia again. An abdominal CT scan indicated a new small intestine mass. Progression continued rapidly, and the patient died of hemorrhagic shock 5.5 months after the resection of the small intestine mass. LESSONS: Although uncommon, if lung cancer patients present with anemia and melena, enteric metastasis should be part of the differential diagnosis. Abdominal CT scans and PET-CT are effective for early diagnosis. The prognosis of metastatic spread of solid subtype lung adenocarcinoma to the small intestine with mesenteric lymph node metastasis is poor. Subgroups of patients benefitting from metastasectomy and more effective systemic therapy need to be further investigated.
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spelling pubmed-55720022017-09-06 Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report Ying, Xiaofang Wang, Mingwei Verma, Vivek Wang, Manxiang Ye, Shengwei Bi, Jianping Zhou, Xiaoyi Han, Guang Zhen, Weining Medicine (Baltimore) 5700 RATIONALE: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. PATIENT CONCERNS: Clinical data and treatment of a 59-year-old man with small intestine metastasis from primary solid subtype lung adenocarcinoma are summarized. DIAGNOSES: A man who was previously diagnosed with stage IIIA (T3N2M0) lung adenocarcinoma (solid subtype) came to our hospital for postoperative radiotherapy. Laboratory tests indicated anemia and melena. The patient was initially believed to have digestive ulcer and was treated with omeprazole, which proved to be ineffective. We conducted an abdominal computed tomography (CT) contrast scan and discovered a mass in the small intestine mass. Further positron emission tomography–computed tomography (PET-CT) imaging indicated the small intestine mass with fluorodeoxyglucose uptake. INTERVENTIONS: The patient underwent an enterectomy and anastomosis. Pathological analysis confirmed the diagnosis of small intestinal metastasis from lung cancer with concomitant mesenteric lymph node metastasis. OUTCOMES: One month after the operation, hemoglobin levels became normal, and the patient had good quality of life. However, 3 months after the operation, the patient suffered from anemia again. An abdominal CT scan indicated a new small intestine mass. Progression continued rapidly, and the patient died of hemorrhagic shock 5.5 months after the resection of the small intestine mass. LESSONS: Although uncommon, if lung cancer patients present with anemia and melena, enteric metastasis should be part of the differential diagnosis. Abdominal CT scans and PET-CT are effective for early diagnosis. The prognosis of metastatic spread of solid subtype lung adenocarcinoma to the small intestine with mesenteric lymph node metastasis is poor. Subgroups of patients benefitting from metastasectomy and more effective systemic therapy need to be further investigated. Wolters Kluwer Health 2017-08-25 /pmc/articles/PMC5572002/ /pubmed/28834880 http://dx.doi.org/10.1097/MD.0000000000007768 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 5700
Ying, Xiaofang
Wang, Mingwei
Verma, Vivek
Wang, Manxiang
Ye, Shengwei
Bi, Jianping
Zhou, Xiaoyi
Han, Guang
Zhen, Weining
Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report
title Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report
title_full Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report
title_fullStr Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report
title_full_unstemmed Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report
title_short Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report
title_sort metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: a case report
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5572002/
https://www.ncbi.nlm.nih.gov/pubmed/28834880
http://dx.doi.org/10.1097/MD.0000000000007768
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