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Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report

RATIONALE: About 50% of patients with a diagnosis of nonsmall cell lung carcinoma exhibit metastatic disease at the time of diagnosis. The preferential sites of extrapulmonary spread are the lymph nodes, liver, brain, adrenal glands, and bones; gastrointestinal tract perforation secondary to metasta...

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Autores principales: Wang, Jian, Chen, Yimeng, Zhang, Sisi, Chen, Qingyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310494/
https://www.ncbi.nlm.nih.gov/pubmed/30544434
http://dx.doi.org/10.1097/MD.0000000000013469
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author Wang, Jian
Chen, Yimeng
Zhang, Sisi
Chen, Qingyong
author_facet Wang, Jian
Chen, Yimeng
Zhang, Sisi
Chen, Qingyong
author_sort Wang, Jian
collection PubMed
description RATIONALE: About 50% of patients with a diagnosis of nonsmall cell lung carcinoma exhibit metastatic disease at the time of diagnosis. The preferential sites of extrapulmonary spread are the lymph nodes, liver, brain, adrenal glands, and bones; gastrointestinal tract perforation secondary to metastatic lung cancer is extremely rare. PATIENT CONCERNS: A 60-year-old male nonsmoker patient presented with a 20-day history of facial, neck, and right upper limb edema. Physical examination revealed a 3.5 cm mass in his right chest. Computed tomography (CT) revealed a 4 cm mass near the right lung hilum. DIAGNOSIS: Biopsy of the right chest wall mass revealed low differentiated lung adenocarcinoma. Additionally, retroperitoneal lymphadenopathy, pericardial effusion, metastases in the mediastinum, bilateral adrenal gland, and right thoracic wall nodule, as well as multiple bone metastases were also found. INTERVENTIONS: Since the patient was diagnosed with multiple metastatic lung cancer, chemotherapy was started. One week after chemotherapy, he experienced a sudden acute abdominal pain. Abdominal CT examination indicated the possibility of intestinal perforation. Hence, the patient underwent an emergency operation. During the surgical procedure, 2 perforations of size 1×1 cm(2) were discovered at 110 cm and 140 cm of the jejunum from Treitz's ligament. Then, an intestinal resection and end-to-end anastomosis were performed. The pathological diagnosis of the resected specimen revealed that it was a metastatic lung adenocarcinoma of small intestine. OUTCOMES: The patient died 10 days after operation and 19 days following the cancer diagnosis due to septic shock. LESSONS: Gastrointestinal tract metastasis from the lung is uncommon, but the survival rate is extremely low; therefore, it should be considered as a possibility in patients who present with any of the gastrointestinal symptoms.
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spelling pubmed-63104942019-01-14 Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report Wang, Jian Chen, Yimeng Zhang, Sisi Chen, Qingyong Medicine (Baltimore) Research Article RATIONALE: About 50% of patients with a diagnosis of nonsmall cell lung carcinoma exhibit metastatic disease at the time of diagnosis. The preferential sites of extrapulmonary spread are the lymph nodes, liver, brain, adrenal glands, and bones; gastrointestinal tract perforation secondary to metastatic lung cancer is extremely rare. PATIENT CONCERNS: A 60-year-old male nonsmoker patient presented with a 20-day history of facial, neck, and right upper limb edema. Physical examination revealed a 3.5 cm mass in his right chest. Computed tomography (CT) revealed a 4 cm mass near the right lung hilum. DIAGNOSIS: Biopsy of the right chest wall mass revealed low differentiated lung adenocarcinoma. Additionally, retroperitoneal lymphadenopathy, pericardial effusion, metastases in the mediastinum, bilateral adrenal gland, and right thoracic wall nodule, as well as multiple bone metastases were also found. INTERVENTIONS: Since the patient was diagnosed with multiple metastatic lung cancer, chemotherapy was started. One week after chemotherapy, he experienced a sudden acute abdominal pain. Abdominal CT examination indicated the possibility of intestinal perforation. Hence, the patient underwent an emergency operation. During the surgical procedure, 2 perforations of size 1×1 cm(2) were discovered at 110 cm and 140 cm of the jejunum from Treitz's ligament. Then, an intestinal resection and end-to-end anastomosis were performed. The pathological diagnosis of the resected specimen revealed that it was a metastatic lung adenocarcinoma of small intestine. OUTCOMES: The patient died 10 days after operation and 19 days following the cancer diagnosis due to septic shock. LESSONS: Gastrointestinal tract metastasis from the lung is uncommon, but the survival rate is extremely low; therefore, it should be considered as a possibility in patients who present with any of the gastrointestinal symptoms. Wolters Kluwer Health 2018-12-10 /pmc/articles/PMC6310494/ /pubmed/30544434 http://dx.doi.org/10.1097/MD.0000000000013469 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Wang, Jian
Chen, Yimeng
Zhang, Sisi
Chen, Qingyong
Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report
title Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report
title_full Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report
title_fullStr Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report
title_full_unstemmed Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report
title_short Perforation of small intestine secondary to metastatic lung adenocarcinoma: A case report
title_sort perforation of small intestine secondary to metastatic lung adenocarcinoma: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310494/
https://www.ncbi.nlm.nih.gov/pubmed/30544434
http://dx.doi.org/10.1097/MD.0000000000013469
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