Zhu Minjie, Shu Jianchang, Liu Xuyou, Leng Lei, Wen Qi
Department of Gastroenterology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, Guangdong 510000, P.R. China.
Department of Pathology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, Guangdong 510000, P.R. China.
Mol Clin Oncol. 2021 Mar;14(3):62. doi: 10.3892/mco.2021.2224. Epub 2021 Jan 25.
The present case study reported a rare case of duodenal metastasis from a lung adenocarcinoma. A 62-year-old male, who underwent radical lung cancer surgery two years ago, was readmitted to Guangzhou Red Cross Hospital complaining of epigastric pain. The esophagogastroduodenoscopy identified a 2.5x3.5 cm ulcerative lesion at the duodenum. Histopathological and immunohistochemical staining results confirmed that the lung adenocarcinoma had metastasized to the duodenum. The tumor cells were positive for cytokeratin-7, thyroid transcription factor-1 and napsin-A expression, but negative for caudal-related homeobox 2 expression. Prior to the second cycle of targeted treatment with anlotinib, the patient reported severe hematochezia. Therefore, an angiography and artery embolization were subsequently performed. However, the patient succumbed to acute kidney injury three days after the operation. The metastasis of lung cancer to the gastrointestinal tract is extremely rare and usually asymptomatic. However, when treating patients with lung cancer presenting with digestive symptoms or other distant metastatic sites, clinicians should consider the possibility of gastrointestinal metastasis so that it can be identified in a timely manner. If lesions exist, doctors should locate these and perform biopsies to conduct histopathological and immunohistochemical examinations to make a clear diagnosis.
本病例报告了一例罕见的肺腺癌十二指肠转移病例。一名62岁男性，两年前接受了肺癌根治手术，因上腹部疼痛再次入住广州红十字会医院。食管胃十二指肠镜检查发现十二指肠有一个2.5×3.5厘米的溃疡性病变。组织病理学和免疫组化染色结果证实肺腺癌已转移至十二指肠。肿瘤细胞细胞角蛋白-7、甲状腺转录因子-1和 napsin-A表达呈阳性，但尾相关同源盒2表达呈阴性。在使用安罗替尼进行第二轮靶向治疗之前，患者出现严重便血。因此，随后进行了血管造影和动脉栓塞。然而，患者在术后三天死于急性肾损伤。肺癌转移至胃肠道极为罕见，通常无症状。然而，在治疗出现消化症状或其他远处转移部位的肺癌患者时，临床医生应考虑胃肠道转移的可能性，以便及时发现。如果存在病变，医生应定位并进行活检，进行组织病理学和免疫组化检查以明确诊断。
