A Metastatic Jejunal Tumor from Squamous Cell Carcinoma of the Lung Found in an Intestinal Perforation

Abstract

An 85-year-old male with advanced squamous cell carcinoma of the lung, who was diagnosed about 10 years prior to his current presentation, suddenly complained of abdominal pain and underwent an abdominal computed tomography scan, which revealed free air and massive ascites. He was admitted to our hospital for acute peritonitis and emergency surgery was performed. During the surgical procedure, a perforation of the jejunum was diagnosed and repaired. He was diagnosed to have a metastatic tumor originating from a squamous cell carcinoma of the lung. He improved and was transferred to the former hospital on the 27th postoperative day. Jejunal metastasis from squamous cell carcinoma of the lung is rare, and the prognosis of peritonitis due to a perforated intestinal metastasis from lung cancer is poor. There have been 10 reports of jejunal metastasis of squamous cell carcinoma of the lung reported in Japan between 2000 and 2011. Therefore, when patients with advanced lung cancer present with acute abdomen, it is necessary to keep in mind the possibility of a gastrointestinal metastatic tumor.

Metastatic squamous cell carcinoma from hand skin causing small bowel obstruction: an unusual case presentation

“…Many extra-abdominal SCCs, such as those of the esophagus [ 1 , 2 ], lung [ 3 , 4 ], penis [ 10 ], ovary, pancreas and gallbladder [ 11 ], can metastasize to the small intestine. However, the lung is the most common extra-abdominal site for intestinal metastases [ 3 , 4 , 8 , 9 ]. Clinical manifestations of intestinal metastases include gastrointestinal obstruction, bleeding, perforation and intussusceptions.…”

Metástasis intestinales yeyunales, forma de presentación de un carcinoma pulmonar

“…ECG: ritmo sinusal a 86 latidos/min. Analítica de sangre: anemia microcítica (Hb: 10 g/dl (11,(9)(10)(11)(12)(13)(14)(15)(16)5), VCM: 77,4 (80,2-99,4). Leucocitosis con neutrofilia (20.000 leucocitos/ml (3,5-10,5) con 84% de neutrófilos (37-73).…”

“…Las metástasis de intestino delgado en el carcinoma primitivo de pulmón son excepcionales y sus manifestaciones clínicas raras 2 . Cuando éstas se producen, pueden causar hemorragia, malabsorción, perforación intestinal, o incluso invaginación intestinal 3,4 aunque la forma más frecuente de presentación es la suboclusiónobstrucción intestinal 5 . Ante la presencia de una anemia ferropénica en un paciente con cáncer de pulmón no debemos olvidar las metástasis intestinales como una de las posibles causas de la hemorragia.…”

Jejunal intestinal metastases, a form of presentation of pulmonary carcinoma

“…Cuando éstas se producen, pueden causar hemorragia, malabsorción, perforación intestinal, o incluso invaginación intestinal 3,4 aunque la forma más frecuente de presentación es la suboclusión-obstrucción intestinal 5 . Ante la presencia de una anemia ferropénica en un paciente con cáncer de pulmón no debemos olvidar las metástasis intestinales como una de las posibles causas de la hemorragia.…”