Gastrointestinal Metastasis of Lung Cancer : 2 Case Reports

초록

Introduction Lung cancer is a common neoplasm and frequently metastasizes to contralateral lung, liver, adrenal, and brain. However, gastrointestinal metastasis development is relatively rare, except esophagus localization by local invasion. Case 1 A 66-year-old man was presented with hemoptysis of ten-day duration. As part of the evaluation of these symptoms, a chest X-Ray and chest computed tomography(CT) was performed and showed a right upper lobe 5cm sized well defined round mass. Surgical treatment, lung right lobectomy, was done and confirm 6.0*6.0cm sized, no lymph node metastasis adenosqamous carcinoma(T3N0M0, stage IIb). Adjuvant treatment was commenced with radiotherapy. Two months later the patient presented poor oral intake and hematochezia. Abdominal pelvic CT and colonoscopy showed 8cm sized rectal submucosal tumor, that was located 7cm above from anal verge. Low anterior resection was done and it was confirmed 7.5*7.0cm sized metastatic adenosqamous carcinoma by final pathology report. Patient was started diet and symptomatic control, but after 4 weeks, the patient died as a consequence of cancer cachexia. Case 2 A 74-year-old man was presented with abdominal pain developed 2 weeks ago. Chest CT and abdominal pelvic CT was revealed 2.3*1.7cm sized right lower lobe lung cancer(T1bN0) and mechanical ileus due to enhancing mass in distal ileum. For ileus symptom, small bowel segmental resection was done and it was confirmed 4.3*4.0cm sized, metastatic squamous cell carcinoma. Recommending primary lung cancer surgery and chemotherapy, but was refused by the patient. Observed after 3 months Chest CT and abdominal pelvic CT was performed and showed increased lung mass(4.5*3.6cm) and multiple liver, adrenal, iliac artery metastasis. After 7 months, the patient died because of cancer cachexia. Conclusion GI metastases, especially rectal localization, from lung cancer are uncommon event and, when it happened, worsened the prognosis.