Grenader Tal, Goldberg Anthony
Department of Oncology, Sha'are Zedek Medical Center, P.O. Box 3235, 91031, Jerusalem, Israel.
Onkologie. 2010;33(4):178-80. doi: 10.1159/000292094. Epub 2010 Mar 19.
Despite the early and widespread dissemination of nonsmall cell lung cancer, clinically significant metastases in the small bowel are rare, and when they do occur, the patient is almost always in the terminal stages of the disease.
We report on a patient who presented initially with small bowel obstruction resulting from metastatic spread of a squamous cell carcinoma of the lung. Following surgical removal of the affected bowel, the patient underwent radiofrequency ablation of the lung tumor and subsequent lower lobe resection. The patient continues to be free of disease 2 years from the initial diagnosis.
This report highlights the need for a timely diagnosis of an acute surgical abdomen and for the inclusion of small intestinal metastases in the differential diagnosis of the acute abdomen in a patient with a lung cancer. Resection of the obstructing tumor and postoperative systemic therapy should be considered. In cases of isolated metastases, resection of the primary lung tumor is indicated.
尽管非小细胞肺癌早期广泛传播,但小肠出现具有临床意义的转移很少见,一旦发生,患者几乎总是处于疾病晚期。
我们报告了一名患者,最初因肺鳞状细胞癌转移扩散导致小肠梗阻。在手术切除受累肠段后,患者接受了肺肿瘤的射频消融及随后的下叶切除术。自最初诊断以来,患者已无疾病生存2年。
本报告强调了及时诊断急性腹痛的必要性,以及在肺癌患者急性腹痛的鉴别诊断中应考虑小肠转移。应考虑切除梗阻性肿瘤并进行术后全身治疗。对于孤立转移的病例,应切除原发性肺肿瘤。