A CASE OF SMALL INTESTINAL METASTASIS OF LUNG CANCER PRESENTING ANAL BLEEDING

Abstract

Comparing to cancers of other organs, primary lung cancer tends to metastasize to distant organs because of the biological characteristics of the origin as well as the specificity of the structure of lung tissue. The metastases of lung cancer most frequently appear in the lung, liver, bone, kidney, adrenal gland, and brain, but rarely in the small intestine. This time we experienced a case of jejunal metastasis of lung cancer presenting anal bleeding which was successfully resected. A 54-year-old man was referred to the hospital because of anal bleeding and severe anemia 2 years after a left pneumonectomy for a moderately differentiated adenocarcinoma of the left lung (B6). Radiological examination demonstrated a fist-sized tumor involving the jejunum, 100cm distal from the Treitz ligament. Partial resection of the jejunum en bloc with the mesenteric mass involving the jejunal wall was performed. Histopathologic examination of hte jejunal tumor revealed moderately differentiated adenocarcinoma, confirming the diagnosis of metastasis of pulmonary carcinoma. Small bowel metastasis of pulmonary carcinoma with clinical manifestations in relatively uncommon. There have been 110 cases including ours of small bowel metastasis of pulmonary carcinoma in the literature so far. Postoperative survival period of these patients ranged drom 2 to 26 months, and 84% of the patients died within 6 months after operation. Although prognosis of the patient is poor, resection is indispensable for a better qulity of life.