Colonic Metastasis of Primary Lung Cancer

Bhutta, Salman Idrees; Ahmed, Yasar; Zahid, Talal; Rehman, Habib ur; Nur, Mutaz Mohammed; Mahmood, Tariq; Calvert, Paula

doi:10.1159/000516795

Cited by 3 publications

(6 citation statements)

References 20 publications

(21 reference statements)

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“…The majority of cases of this disease are diagnosed in symptomatic patients, and detection during follow-up, similar to that in our case, is uncommon (6). With over 12% of colonic metastasis from LC in autoptic series, detection during follow-up is also uncommon (9). Gastrointestinal complications usually occur after the diagnosis of LC is established (6).…”

Section: Discussionsupporting

confidence: 75%

Case Report: Recurrent colonic metastasis from lung cancer—diagnostic pitfalls and therapeutic challenge of a peculiar case

Tramontano,

Sarno,

Prisco

et al. 2023

Front. Surg.

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Lung cancer (LC) mortality exceeds 20%, and detecting metastases from LC is becoming a challenging step in understanding the real prognostic role of specific localization. We report a case of a patient with lung metastasis to the colon with local recurrence at the anastomosis after radical resection for metastasis. In both cases, the diagnosis was on oncological follow-up, and surgery was offered in consideration of reasonable life expectancy, good control of LC, and high risk of intestinal occlusion. A 67-year-old male, with a history of LC 18 months ago, was referred to our surgical unit after a positron emission tomography CT total body, where an area of intense glucose metabolism (SUV max: 35.6) at the hepatic colic flexure was reported. A colonoscopy revealed an ulcerated, bleeding large neoplasm distally to hepatic flexure, almost causing resulting total occlusion. Histologic examination revealed a tumor with complete wall thickness infiltration, which appears extensively ulcerated, from poorly differentiated squamous carcinoma (G3), not keratinizing, with growth in large solid nests, often centered by central necrosis. Two of the 30 isolated lymph nodes were metastatic. The omental flap and resection margins were free from infiltration. The malignant cells exhibited strong positive immunoreactivity only for p40. The features supported metastatic squamous carcinoma of lung origin rather than primary colorectal adenocarcinoma. After 8 months from surgery, intense Fluorodeoxyglucose (FDG) uptake of tissue was confirmed in the transverse colon. Colonoscopy evidenced an ulcerated substenotic area that involved ileocolic anastomosis on both sides. Reoperation consisted of radical resection of ileocolic anastomosis with local lymphadenectomy and ileotransverse anastomosis. The second histologic examination also revealed poorly differentiated squamous carcinoma (G3), not keratinizing, with positive immunoreactivity only for p40, suggesting the origin of LC. This case report confirmed that the possibility of colonic secondary disease should be part of the differential diagnosis in asymptomatic patients and those with a history of LC diagnosis. In addition, relapse of colonic metastasis is infrequent but should be considered during follow-up of LC. More studies on colonic metastasis of LC are required to better understand the clinical features and outcomes.

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Section: Discussionsupporting

confidence: 75%

Case Report: Recurrent colonic metastasis from lung cancer—diagnostic pitfalls and therapeutic challenge of a peculiar case

Tramontano,

Sarno,

Prisco

et al. 2023

Front. Surg.

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“…A total of 24 cases[ 12 , 16 , 17 , 22 , 25 , 29 - 34 , 36 - 46 ] of colorectal metastases of lung cancer treated with surgical resection, including our case, have been reported so far (Table 1 ); this includes 18 male (75%) and 6 female (25%) patients with a median age of 61.5 years (range 49-85 years). The most common symptom was abdominal pain, which presented in 14 patients (58.3%), followed by GI bleeding in 5 (20.8%).…”

Section: Discussionmentioning

confidence: 93%

“…Although chemotherapy is the standard treatment for GI metastases, surgical intervention can be applied in patients with clinical symptoms such as bowel obstruction[ 17 , 29 , 30 ], intussusception[ 31 , 32 ], and perforation[ 33 ]. However, surgery for advanced lung cancer with multiple metastases is highly invasive and worsens the patient’s general condition, resulting in various perioperative complications[ 32 - 34 ] with mortality rates of 64%-100%[ 5 , 10 , 35 ]. Meanwhile, a relatively good prognosis can be achieved when GI metastases are curatively resected[ 6 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…There was no specific distribution of colonic metastases. Seven patients (29.2%) had regional lymph node metastasis of the colorectum[ 14 , 28 , 34 , 41 ], and five patients (20.8%) had distant metastasis other than the colorectum such as the liver[ 46 ], stomach[ 47 ], small intestine[ 35 , 48 ], bone[ 49 ], and the bilateral lung[ 25 ]. Most colonic metastases showed the histological appearance of adenocarcinoma (11 patients); squamous cell carcinoma was observed in 7, pleomorphic carcinoma in 2, small cell carcinoma in 2, and adenosquamous cell carcinoma in 2 patients, which were naturally identical to the primary lung cancer.…”

Section: Discussionmentioning

confidence: 99%

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Successful resection of colonic metastasis of lung cancer after colonic stent placement: A case report and review of the literature

Nakayama¹,

Yamaguchi²,

Inoue³

et al. 2023

World J Gastrointest Surg

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Obstructive jaundice (OJ) is a common problem in daily clinical practice. However, completely understanding the pathophysiological changes in OJ remains a challenge for planning current and future management. The effects of OJ are widespread, affecting the biliary tree, hepatic cells, liver function, and causing systemic complications. The lack of bile in the intestine, destruction of the intestinal mucosal barrier, and increased absorption of endotoxins can lead to endotoxemia, production of proinflammatory cytokines, and induce systemic inflammatory response syndrome, ultimately leading to multiple organ dysfunction syndrome. Proper management of OJ includes adequate water supply and electrolyte replacement, nutritional support, preventive antibiotics, pain relief, and itching relief. The surgical treatment of OJ depends on the cause, location, and severity of the obstruction. Biliary drainage, surgery, and endoscopic intervention are potential treatment options depending on the patient's condition. In addition to modern medical treatments, Traditional Chinese medicine may offer therapeutic benefits for OJ. A comprehensive search was conducted on PubMed for relevant articles published up to August 1970. This review discusses in detail the pathophysiological changes associated with OJ and presents effective strategies for managing the condition.

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“…Our diagnosis was confirmed with exploratory laparotomy, which was necessary given the evidence for perforation, yet a CT abdomen done one month prior to this event during initial staging had not revealed metastasis to the small bowel. The use of CT imaging is adequate to confirm perforation or abscess in the setting of an acute abdomen though it is difficult to distinguish small metastatic lesions within the small bowel [10], and PET/CT, which can theoretically show increased uptake to metabolically active lesions, have not shown to demonstrate a diagnostic advantage over CT alone [11]. IHC for the specimen showed CK7 and TTF-1 positively which is in line with Lung Adenocarcinoma, which has been shown in several studies to be the leading type of lung cancer in small bowel metastases [3][4][5]7]; however, other studies may indicate that either squamous cell carcinoma [2,8,9] or large cell carcinoma [6,9] is more likely.…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Perforation Due to Rare Metastasis From Stage IV Lung Adenocarcinoma

Sautto¹,

Tinsley²,

Neychev³

2022

Cureus

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Lung adenocarcinoma commonly metastasizes to the lymph nodes, bone, nervous system, liver, respiratory system, and adrenal gland. Metastasis to the small bowel is extremely rare and the literature deals mostly with few published case reports. We present a case of a 70-year-old male with a previous history of stage IV lung adenocarcinoma with brain and liver metastases treated with radiotherapy and chemotherapy. He presented to the emergency department with peritonitis and sepsis due to bowel perforation. He underwent an emergency exploratory laparotomy and small bowel resection. Surgical pathology revealed metastatic lung adenocarcinoma as the cause of bowel perforation. He tolerated and recovered from surgery well and was discharged on postoperative day 7. On one-month follow-up as an outpatient, he was doing well and had no complications or complaints from his recent surgery.

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Colonic Metastasis of Primary Lung Cancer

Cited by 3 publications

References 20 publications

Case Report: Recurrent colonic metastasis from lung cancer—diagnostic pitfalls and therapeutic challenge of a peculiar case

Case Report: Recurrent colonic metastasis from lung cancer—diagnostic pitfalls and therapeutic challenge of a peculiar case

Successful resection of colonic metastasis of lung cancer after colonic stent placement: A case report and review of the literature

Small Bowel Perforation Due to Rare Metastasis From Stage IV Lung Adenocarcinoma

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