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肺鳞状细胞癌的多发胃肠道转移:一例报告

Multiple gastrointestinal metastases of squamous-cell lung cancer: A case report.

作者信息

Li Xinyu, Li Songhe, Ma Zhiming, Zhao Shutao, Wang Xudong, Wen Dacheng

机构信息

Department of Gastrointestinal Nutrition and Hernia Surgery, the 2nd Hospital of Jilin University Experimental Surgery Division at University of Munich (LMU), Munich, Germany Department of Ophthalmology, the 1st Hospital of Jilin University, Changchun, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(24):e11027. doi: 10.1097/MD.0000000000011027.

Abstract

RATIONALE

Gastrointestinal multiple metastases of lung cancer are extremely rare. The majority of gastrointestinal metastasis cases are diagnosed at a late stage and the prognosis is extremely poor. This report describes the clinical characteristics and outcomes of a patient with gastrointestinal multiple metastases from squamous-cell lung cancer, with special emphasis on the diagnosis and treatment of metastatic lung cancer.

PATIENT CONCERNS

A 61-year-old man who presented with progressive abdominal distention was admitted to our hospital. Radiological examinations showed changes of post-primary pulmonary tuberculosis and mechanical obstruction of the small bowl. Histopathological findings of gastroscopic examination and biopsy specimens showed a diagnosis of squamous-cell carcinoma in the body of the stomach.

DIAGNOSES

Postoperative histopathology confirmed a gastrointestinal multiple squamous-cell carcinoma in stomach and small bowl. Finally, squamous-cell lung cancer was confirmed by lung biopsy.

INTERVENTIONS

During his hospitalization urgent surgery was performed because of acute abdomen. The patient underwent a laparotomy with curative gastrectomy for gastric cancer and small bowel partial resection. The patient was recommended with combination chemotherapy of carboplatin and paclitaxel for 3 cycles.

OUTCOMES

Six months later after operation, the patient succumbed to respiratory failure.

LESSONS

We searched the related literature of gastrointestinal metastases from lung cancer and the clinical presentation, site of metastasis, diagnosis, treatment, and survival time in these cases were reviewed. The present study may increase the awareness of early diagnosis and appropriate treatment of metastatic lung cancer of gastrointestinal tract.

摘要

理论依据

肺癌的胃肠道多发转移极为罕见。大多数胃肠道转移病例在晚期被诊断出来,预后极差。本报告描述了一名鳞状细胞肺癌发生胃肠道多发转移患者的临床特征及治疗结果,特别强调了转移性肺癌的诊断和治疗。

患者情况

一名61岁男性因进行性腹胀入院。影像学检查显示原发性肺结核后遗症及小肠机械性梗阻。胃镜检查及活检标本的组织病理学检查结果显示胃体部为鳞状细胞癌。

诊断

术后组织病理学证实胃和小肠为胃肠道多发鳞状细胞癌。最终,经肺活检确诊为鳞状细胞肺癌。

干预措施

住院期间,因急腹症进行了紧急手术。患者接受了胃癌根治性胃切除术及小肠部分切除术的剖腹手术。建议患者接受卡铂和紫杉醇联合化疗3个周期。

结果

术后6个月,患者死于呼吸衰竭。

经验教训

我们检索了肺癌胃肠道转移的相关文献,并对这些病例的临床表现、转移部位、诊断、治疗及生存时间进行了综述。本研究可能会提高对胃肠道转移性肺癌早期诊断及恰当治疗的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7124/6023823/b9a18afd3054/medi-97-e11027-g001.jpg

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