Lung carcinoma with small intestinal metastases and gastrointestinal bleeding: A rare case report

Liu,Tianzi; Geng,Yan; Wang,Zichuan; Peng,Xintong; Liu,Jing; Huang,Yan

doi:10.3892/ol.2023.13827

Lung carcinoma with small intestinal metastases and gastrointestinal bleeding: A rare case report

Authors:
- Tianzi Liu
- Yan Geng
- Zichuan Wang
- Xintong Peng
- Jing Liu
- Yan Huang
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Affiliations: School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261053, P.R. China, Department of Oncology, The Affiliated Hospital of Weifang Medical University, Weifang, Shandong 261041, P.R. China
Published online on: April 20, 2023 https://doi.org/10.3892/ol.2023.13827
Article Number: 241
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The occurrence of small intestinal metastases from primary lung cancer is rare. This report documents the case of a 57‑year‑old male patient initially diagnosed with non‑metastatic lung adenocarcinoma, who presented with abdominal pain 6 months later. Postoperative pathological analysis confirmed the final diagnosis to be small intestinal metastasis from primary lung cancer. Thoracoscopic surgery and systemic chemotherapy were the preferred treatment options. However, the lung tumor spread to the small intestine, causing intestinal obstruction. As the patient could not tolerate anti‑tumor therapy, only symptomatic treatment was provided. The patient experienced massive gastrointestinal bleeding and died the next day. Although small intestinal metastasis from lung cancer is rare and difficult to diagnose accurately, it should be considered when encountering a patient with lung cancer exhibiting abdominal symptoms and associated imaging findings. At this point, a pathological diagnosis should be performed immediately to determine the nature and source of the tumor. Furthermore, individualized treatment should be conducted in strict accordance with oncology guidelines. Of note, early detection and treatment are critical to ensure favorable outcomes.

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1	Balata H, Fong KM, Hendriks LE, Lam S, Ostroff JS, Peled N, Wu N and Aggarwal C: Prevention and early detection for NSCLC: Advances in thoracic oncology 2018. J Thorac Oncol. 14:1513–1527. 2019. View Article : Google Scholar : PubMed/NCBI
2	Xia C, Dong X, Li H, Cao M, Sun D, He S, Yang F, Yan X, Zhang S, Li N and Chen W: Cancer statistics in China and United States, 2022: profiles, trends, and determinants. Chin Med J (Engl). 135:584–590. 2022. View Article : Google Scholar : PubMed/NCBI
3	Siegel RL, Miller KD, Fuchs HE and Jemal A: Cancer statistics, 2022. CA Cancer J Clin. 72:7–33. 2022. View Article : Google Scholar : PubMed/NCBI
4	Niu FY, Zhou Q, Yang JJ, Zhong WZ, Chen ZH, Deng W, He YY, Chen HJ, Zeng Z, Ke EE, et al: Distribution and prognosis of uncommon metastases from non-small cell lung cancer. BMC Cancer. 16:1492016. View Article : Google Scholar : PubMed/NCBI
5	Hu Y, Feit N, Huang Y, Xu W, Zheng S and Li X: Gastrointestinal metastasis of primary lung cancer: An analysis of 366 cases. Oncol Lett. 15:9766–9776. 2018.PubMed/NCBI
6	Yoshimoto A, Kasahara K and Kawashima A: Gastrointestinal metastases from primary lung cancer. Eur J Cancer. 42:3157–3160. 2006. View Article : Google Scholar : PubMed/NCBI
7	Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, Nicholson AG, Groome P, Mitchell A, Bolejack V, et al: The IASLC lung cancer staging project: Proposals for revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 11:39–51. 2016. View Article : Google Scholar : PubMed/NCBI
8	Neeman E, Gresham G, Ovasapians N, Hendifar A, Tuli R, Figlin R and Shinde A: Comparing physician and nurse eastern cooperative oncology group performance status (ECOG-PS) ratings as predictors of clinical outcomes in patients with cancer. Oncologist. 24:e1460–e1466. 2019. View Article : Google Scholar : PubMed/NCBI
9	Herbst RS, Morgensztern D and Boshoff C: The biology and management of non-small cell lung cancer. Nature. 553:446–454. 2018. View Article : Google Scholar : PubMed/NCBI
10	Barta JA, Powell CA and Wisnivesky JP: Global epidemiology of lung cancer. Ann Glob Health. 85:82019. View Article : Google Scholar : PubMed/NCBI
11	Hoffman PC, Mauer AM and Vokes EE: Lung cancer. Lancet. 355:479–485. 2000. View Article : Google Scholar : PubMed/NCBI
12	McNeill PM, Wagman LD and Neifeld JP: Small bowel metastases from primary carcinoma of the lung. Cancer. 59:1486–1489. 1987. View Article : Google Scholar : PubMed/NCBI
13	Hung TI, Chu KE, Chou YH and Yang KC: Gastric metastasis of lung cancer mimicking an adrenal tumor. Case Rep Gastroenterol. 8:77–81. 2014. View Article : Google Scholar : PubMed/NCBI
14	Jevremovic V: Is gastrointestinal metastasis of primary lung malignancy as rare as reported in the literature? A comparison between clinical cases and post-mortem studies. Stud Oncol Hematol Rev. 12:51–57. 2016.
15	Yamada H, Akahane T, Horiuchi A, Shimada R, Shibuya H, Hayama T, Nozawa K, Ishihara S, Matsuda K and Watanabe T: A case of lung squamous cell carcinoma with metastases to the duodenum and small intestine. Int Surg. 96:176–181. 2011. View Article : Google Scholar : PubMed/NCBI
16	Janež J: Acute intestinal obstruction due to metastatic lung cancer-case report. J Surg Case Rep. 2017:rjx0312017. View Article : Google Scholar : PubMed/NCBI
17	Di JZ, Peng JY and Wang ZG: Prevalence, clinicopathological characteristics, treatment, and rognosis of intestinal metastasis of primary lung cancer: A comprehensive review. Surg Oncol. 23:72–80. 2014. View Article : Google Scholar : PubMed/NCBI
18	Yang CJ, Hwang JJ, Kang WY, Chong IW, Wang TH, Sheu CC, Tsai JR and Huang MS: Gastro-intestinal metastasis of primary lung carcinoma: Clinical presentations and outcome. Lung Cancer. 54:319–323. 2006. View Article : Google Scholar : PubMed/NCBI
19	Xue C, Hu Z, Jiang W, Zhao Y, Xu F, Huang Y, Zhao H, Wu J, Zhang Y, Zhao L, et al: National survey of the medical treatment status for non-small cell lung cancer (NSCLC) in China. Lung Cancer. 77:371–375. 2012. View Article : Google Scholar : PubMed/NCBI
20	Kim SY, Ha HK, Park SW, Kang J, Kim KW, Lee SS, Park SH and Kim AY: Gastrointestinal metastasis from primary lung cancer: CT findings and clinicopathologic features. AJR Am J Roentgenol. 193:W197–W201. 2009. View Article : Google Scholar : PubMed/NCBI
21	Lardinois D, Weder W, Roudas M, von Schulthess GK, Tutic M, Moch H, Stahel RA and Steinert HC: Etiology of solitary extrapulmonary positron emission tomography and computed tomography findings in patients with lung cancer. J Clin Oncol. 23:6846–6853. 2005. View Article : Google Scholar : PubMed/NCBI
22	Stinchcombe TE, Socinski MA, Gangarosa LM and Khandani AH: Lung cancer presenting with a solitary colon metastasis detected on positron emission tomography scan. J Clin Oncol. 24:4939–4940. 2006. View Article : Google Scholar : PubMed/NCBI
23	Rossi G, Marchioni A, Romagnani E, Bertolini F, Longo L, Cavazza A and Barbieri F: Primary lung cancer presenting with gastrointestinal tract involvement: Clinicopathologic and immunohistochemical features in a series of 18 consecutive cases. J Thorac Oncol. 2:115–120. 2007. View Article : Google Scholar : PubMed/NCBI
24	Sakai H, Egi H, Hinoi T, Tokunaga M, Kawaguchi Y, Shinomura M, Adachi T, Arihiro K and Ohda H: Primary lung cancer presenting with metastasis to the colon: A case report. World J Surg Oncol. 10:1–5. 2012. View Article : Google Scholar
25	Goh BK, Yeo AW, Koong HN, Ooi LL and Wong WK: Laparotomy for acute complications of gastrointestinal metastases from lung cancer: Is it a worthwhile or futile effort? Surg Today. 37:370–374. 2007. View Article : Google Scholar : PubMed/NCBI
26	Liu W, Zhou W, Qi WL, Ma YD and Xu YY: Gastrointestinal hemorrhage due to ileal metastasis from primary lung cancer. World J Gastroenterol. 21:3435–3440. 2015. View Article : Google Scholar : PubMed/NCBI
27	Nitipir C, Ginghina O, Popa L, Andrei F, Tudor N, Radu I, Iaciu C, Orlov C, Vasilescu F, Balalau C, et al: A rare case of advanced lung cancer presenting as a symptomatic gastric tumor. Mol Clin Oncol. 8:595–599. 2018.PubMed/NCBI
28	AlSaeed EF, Tunio MA, AlSayari K, AlDandan S and Riaz K: Duodenal metastasis from lung adenocarcinoma: A rare cause of melena. Int J Surg Case Rep. 13:91–94. 2015. View Article : Google Scholar : PubMed/NCBI
29	Letaief-Ksontini F, Boujnah R, Yahiaoui Y, Zaimi Y, Ksentini M, Aloui R, Meddeb K and Mezlini A: An acute jejunojejunal intussusception revealing a metastatic combined lung cancer. Case Rep Surg. 2021:99996052021.PubMed/NCBI
30	Rittmeyer A, Barlesi F, Waterkamp D, Park K, Ciardiello F, von Pawel J, Gadgeel SM, Hida T, Kowalski DM, Dols MC, et al: Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): A phase 3, open-label, multicentre randomised controlled trial. Lancet. 389:255–265. 2017. View Article : Google Scholar : PubMed/NCBI
31	Vokes EE, Ready N, Felip E, Horn L, Burgio MA, Antonia SJ, Aren Frontera O, Gettinger S, Holgado E, Spigel D, et al: Nivolumab versus docetaxel in previously treated advanced non-small-cell lung cancer (CheckMate 017 and CheckMate 057): 3-year update and outcomes in patients with liver metastases. Ann Oncol. 29:959–965. 2018. View Article : Google Scholar : PubMed/NCBI
32	Socinski MA, Jotte RM, Cappuzzo F, Orlandi F, Stroyakovskiy D, Nogami N, Rodriguez-Abreu D, Moro-Sibilot D, Thomas CA, Barlesi F, et al: Atezolizumab for First-Line Treatment of Metastatic Nonsquamous NSCLC. N Engl J Med. 378:2288–2301. 2018. View Article : Google Scholar : PubMed/NCBI
33	Mo H, Huang J, Xu J, Chen X, Wu D, Qu D, Wang X, Lan B, Wang X, Xu J, et al: Safety, anti-tumour activity, and pharmacokinetics of fixed-dose SHR-1210, an anti-PD-1 antibody in advanced solid tumours: A dose-escalation, phase 1 study. Br J Cancer. 119:538–545. 2018. View Article : Google Scholar : PubMed/NCBI
34	Zhou C, Chen G, Huang Y, Zhou J, Lin L, Feng J, Wang Z, Shu Y, Shi J, Hu Y, et al: Camrelizumab plus carboplatin and pemetrexed versus chemotherapy alone in chemotherapy-naive patients with advanced non-squamous non-small-cell lung cancer (CameL): A randomised, open-label, multicentre, phase 3 trial. Lancet Respir Med. 9:305–314. 2021. View Article : Google Scholar : PubMed/NCBI
35	Hou X, Zhou C, Wu G, Lin W, Xie Z, Zhang H, Yi J, Peng Z, Yin L, Ma C and Chen L: Efficacy, safety, and health-related quality of life with camrelizumab plus pemetrexed and carboplatin as first-line treatment for advanced nonsquamous NSCLC with brain metastases (CAP-BRAIN): A multicenter, open-label, single-arm, phase 2 study. J Thorac Oncol. 2:S1556–S0864(23)00092-8. 2023.
36	Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman JR, Bharat A, Bruno DS, Chang JY, Chirieac LR, D'Amico TA, et al: Non-small cell lung cancer, version 3.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 20:497–530. 2022. View Article : Google Scholar : PubMed/NCBI
37	Zhou C, Chen G, Huang Y, Zhou J, Lin L, Feng J, Wang Z, Shu Y, Shi J, Hu Y, et al: Camrelizumab plus carboplatin and pemetrexed as first-line treatment for advanced nonsquamous NSCLC: Extended follow-up of camel phase 3 trial. J Thorac Oncol. 13:S1556S0864(22)01993-1. 2023.