Gastrointestinal bleeding due to pancreatic metastasis of non-small cell lung cancer: A report of two cases and a literature review

Zheng,Yulong; Gao,Qiqi; Fang,Weijia; Xu,Nong; Zhou,Jianying

doi:10.3892/ol.2015.3035

Gastrointestinal bleeding due to pancreatic metastasis of non-small cell lung cancer: A report of two cases and a literature review

Authors:
- Yulong Zheng
- Qiqi Gao
- Weijia Fang
- Nong Xu
- Jianying Zhou
View Affiliations

Affiliations: Department of Medical Oncology, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China, Department of Pathology, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China, Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
Published online on: March 12, 2015 https://doi.org/10.3892/ol.2015.3035
Pages: 2041-2045
Copyright: © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The current study presents two cases of gastrointestinal (GI) bleeding due to pancreatic metastasis of non‑small cell lung cancer (NSCLC). The two patients had a history of lung adenocarcinoma prior to pancreatic metastasis. The first patient presented with melena, epigastric pain and weight loss, and the second patient presented with melena and weight loss. The diagnoses were confirmed by biopsy of the metastatic lesions. Immunohistochemistry is useful for managing the differential diagnosis between lung cancer and pancreatic carcinoma in patients with a history of lung cancer. Chemotherapy prolonged the survival of the second patient. However, the first patient received no chemotherapy and succumbed to NSCLC six weeks after the diagnosis of metastatic pancreatic cancer. GI bleeding as a result of pancreatic metastasis of NSCLC is extremely rare; including the present two cases, only three cases have been reported in the English literature. The current study is presented in order to increase the awareness of GI hemorrhage as a manifestation of this relatively rare condition.

View Figures

View References

1	Breathnach OS, Freidlin B, Conley B, et al: Twenty-two years of phase III trials for patients with advanced non-small-cell lung cancer: sobering results. J Clin Oncol. 19:1734–1742. 2001.PubMed/NCBI
2	Quint LE, Tummala S, Brisson LJ, et al: Distribution of distant metastases from newly diagnosed non-small cell lung cancer. Ann Thorac Surg. 62:246–250. 1996. View Article : Google Scholar : PubMed/NCBI
3	Line DH and Deeley TJ: The necropsy findings in carcinoma of the bronchus. Br J Dis Chest. 65:238–242. 1971. View Article : Google Scholar : PubMed/NCBI
4	Nakamura E, Shimizu M, Itoh T and Manabe T: Secondary tumors of the pancreas: clinicopathological study of 103 autopsy cases of Japanese patients. Pathol Int. 51:686–690. 2001. View Article : Google Scholar : PubMed/NCBI
5	Adsay NV, Andea A, Basturk O, Kilinc N, Nassar H and Cheng JD: Secondary tumors of the pancreas: an analysis of asurgical and autopsydatabase and review of the literature. Virchows Arch. 444:527–535. 2004. View Article : Google Scholar : PubMed/NCBI
6	Z'Graggen K, Fernández-del Castillo C, Rattner DW, Sigala H and Warshaw AL: Metastases to thepancreas and their surgical extirpation. Arch Surg. 133:413–417. discussion 418-4191998. View Article : Google Scholar : PubMed/NCBI
7	Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL and Trotti A: American Joint Committee on Cancer (AJCC) Cancer Staging Manual. 7th. Springer, Inc.; Chicago, IL: 2010
8	Oken MM, Creech RH, Tormey DC, et al: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI
9	Zerbi A and Pecorelli N: Pancreatic metastases: An increasing clinical entity. World J Gastrointest Surg. 2:255–259. 2010. View Article : Google Scholar : PubMed/NCBI
10	Bestari MB and Agustanti N: Obstructive jaundice due to pancreatic metastasis from non-small cell lung cancer. Acta Med Indones. 45:216–219. 2013.PubMed/NCBI
11	Merkle EM, Boaz T, Kolokythas O, Haaga JR, Lewin JS and Brambs HJ: Metastases to the pancreas. Br J Radiol. 71:1208–1214. 1998. View Article : Google Scholar : PubMed/NCBI
12	Pericleous S, Mukherjee S and Hutchins RR: Lung adenocarcinoma presenting as obstructive jaundice: a casereport and review of literature. World J Surg Oncol. 6:1202008. View Article : Google Scholar : PubMed/NCBI
13	Liu SF, Zhang S, Chen YC, et al: Experience of cancer care for metastasis-induced acute pancreatitis patients with lung cancer. J Thorac Oncol. 4:1231–1235. 2009. View Article : Google Scholar : PubMed/NCBI
14	Schwarz RE, Chu PG and Grannis FW Jr: Pancreatic tumors in patients with lung malignancies: a spectrum of clinicopathologic considerations. South Med J. 97:811–815. 2004. View Article : Google Scholar : PubMed/NCBI
15	Sato M, Okumura T, Kaito K, et al: Usefulness of FDG-PET/CT in the detection of pancreatic metastases from lung cancer. Ann Nucl Med. 23:49–57. 2009. View Article : Google Scholar : PubMed/NCBI
16	Xi-wen S and Shu-zhen C: Characterization of pancreatic metastases from primary lung cancer using magnetic resonance imaging. Clin Imaging. 34:351–354. 2010. View Article : Google Scholar : PubMed/NCBI
17	Onuigbo WI: Lung cancer metastasis to thepancreas and its surrounding lymph nodes. Br J Dis Chest. 60:152–155. 1966. View Article : Google Scholar : PubMed/NCBI
18	Harlamert HA, Mira J, Bejarano PA, et al: Thyroid transcription factor-1 and cytokeratins 7 and 20 inpulmonary and breast carcinoma. Acta Cytol. 42:1382–1388. 1998. View Article : Google Scholar : PubMed/NCBI
19	Mori N, Sawada T, Satoh H, Kawaguchi M, Hara H and Matsushita K: A resected case of solitary pancreatic metastasis from adenocarcinoma of the lung. JOP. 9:698–703. 2008.PubMed/NCBI
20	Maeno T, Satoh H, Ishikawa H, et al: Patterns of pancreatic metastasis from lung cancer. Anticancer Res. 18:2881–2884. 1998.PubMed/NCBI
21	Mok T, Yang JJ and Lam KC: Treating patients with EGFR-sensitizing mutations: first line or second line - is there a difference? J Clin Oncol. 31:1081–1088. 2013. View Article : Google Scholar : PubMed/NCBI
22	Shaw AT, Yeap BY, Solomon BJ, et al: Effect of crizotinib on overall survival in patients with advanced non-small-cell lung cancer harbouring ALK gene rearrangement: a retrospective analysis. Lancet Oncol. 12:1004–1012. 2011. View Article : Google Scholar : PubMed/NCBI