Solitary gastric metastasis from primary lung adenocarcinoma: a rare site of extra-thoracic metastatic disease.

Abstract

Lung cancer metastasizing to gastrointestinal (GI)-tract is a rare event. Gastric metastasis is usually asymptomatic but when mucosal in location it may cause symptoms as demonstrated in the current case. This report describes a 60-year old male who was admitted for evaluation of a left upper lobe lung mass with associated bilateral nodular opacities and mediastinal lymphadenopathy. After thorough work-up the diagnosis of advanced lung adenocarcinoma was made. During hospitalization period and prior to starting chemotherapy, he exhibited upper gastrointentinal bleeding. Esophagogastroduodenoscopy revealed an ulcerative lesion in the gastric corpus representing metastasis of the primary lung carcinoma that ensued from immunohistochemical analysis. Clinical, pathological and therapeutic aspects of this uncommon site of extrathoracic metastatic disease are discussed, emphasizing the importance of the immunohistochemistry in the differential diagnosis of lung carcinomas whether primary or secondary to the lung.