Gastrointestinal metastases from malignant tumors of the lung

Abstract

Autopsy data of 423 cases of primary tumor of the lung over a 36-year period were evaluated for the presence of gastrointestinal tract metastases. Fifty-eight cases (14%) were found and were analyzed for histologic nature of tumor, anatomic location, symptomatology and complications. The most common histologic type of lung tumor causing gastrointestinal tract metastasis was squamous cell (19 cases, 33%), followed by large cell (17 cases, 29%), and oat cell (11 cases, 19%). The esophagus was the most common site of involvement (33 cases). Fourteen of the 33 cases were involved by direct extension of the tumor. The middle third of the esophagus had metastases more commonly (16/33, 49%) than the other two sites. Most patients with gastrointestinal metastases had no symptoms. In those patients with symptoms, dysphagia was most common when the tumor involved the proximal gastrointestinal tract (esophagus, stomach), whereas, pain was most commonly seen with involvement of the distal gastrointestinal tract (small bowel, large bowel). Six of 20 patients (30%) with small bowel involvement experienced perforation and peritonitis as complications of metastatic involvement and two patients with large bowel metastasis had obstruction; a third had dehiscence of a previous anastomotic site. Gastrointestinal tract metastases from primary carcinoma of the lung are more common than previously thought and may be associated with serious clinical complications.

Analysis of gastrointestinal metastasis of primary lung cancer: Clinical characteristics and prognosis

“…According to several autopsy studies, gastrointestinal metastasis of primary lung cancer occurs in 4.7-14.0% of cases (3)(4)(5). However, in past clinical studies, the incidence of gastrointestinal metastasis has been reported to be as low as 0.2-1.7% (5)(6)(7)(8), and in the current study, the clinical prevalence of gastrointestinal metastasis of lung cancer was ~0.33% (7/2,066).…”

“…However, the clinical incidence of gastrointestinal metastasis of lung cancer has been reported to be as low as 0.2-1.7% (3)(4)(5)(6)(7)(8). By contrast, the rate of metastasis of primary lung cancer to the gastrointestinal tract in autopsy studies is higher than the clinical frequency of gastrointestinal metastasis.…”

An unusual presentation of metastatic lung cancer

“…Even though all cell types of primary lung cancer may have metastasis to small bowel, Antler et al reported that gastrointestinal metastases were more common in cases where large cell and small cell histology was seen in the primary tumour. 4,5,13 While presentation of the small intestinal metastases may be as perforation, obstruction, malabsorption and/or haemorrhage, Leidich and Rudolph have explained the pathogenesis in that the tumour cells from the primary, spread to the bowel wall either by haematogenous or lymphatic spread. 7 The tumour replaces all or part of the bowel wall resulting in various symptoms: viable bulky tumour causes obstruction, necrotic tumour perforates, ulcerative lesions bleed and extensive mucosal surface involvement leads to malabsorption.…”

A Squamous Lung Cancer Case with Ileum Metastasis

“…Hasta ileum metastazı tanısı aldıktan sonra medikal onkoloji ile görü-şülerek genel durumunun toplaması ve sonrasında tekrar kemoterapi planlanması açısından poliklinik kontrolü önerilerek taburcu edildi. (3,4). Bizim olgumuzda da tutulan bölge ileumdu.…”