Department of Medical Oncology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Interventional Radiology Department, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Medicine (Baltimore). 2024 Oct 11;103(41):e40058. doi: 10.1097/MD.0000000000040058.
Metastatic tumors in the stomach and small bowel are rare. This article reports a case of lung adenocarcinoma metastasizing to the stomach and small bowel.
This case study presents the medical history of a 41-year-old male construction worker with a 1-month-long cough and slight chest discomfort. Imaging revealed a tumor in the right middle lobe of the lung, with metastasis to lymph nodes in the mediastinum and right hilar region, as well as a mass in the stomach's greater curvature and multiple lymph node metastases in the abdomen. Thirty-five days after the initial consultation, the patient exhibited worsening symptoms of vomiting and melena. A follow-up computed tomography scan revealed small bowel metastasis, leading to secondary intestinal obstruction and intussusception.
Biopsies confirmed poorly differentiated adenocarcinoma in the lung and stomach, with immunohistochemistry supporting a diagnosis of lung adenocarcinoma. Genetic testing showed no mutations or amplification in various genes.
The patient received interventional hemostatic treatment; however, the efficacy of the intervention was poor.
The patient experienced worsening gastrointestinal symptoms. Despite attempted intervention, the patient ultimately died 78 days after seeking medical attention.
The case of lung cancer metastasizing to the stomach and small bowel presented in this article demonstrates high invasiveness and rapid progression. Combined with literature reports, this type of metastasis often indicates a poor prognosis for patients. The long-term benefits of surgical resection remain unclear, and further analysis will be needed with more cases and data in the future.
胃和小肠转移瘤较为罕见。本文报告了一例肺腺癌转移至胃和小肠的病例。
本病例研究介绍了一名 41 岁男性建筑工人的病史,他有 1 个月的咳嗽和轻微胸痛。影像学检查显示右肺中叶有肿瘤,纵隔和右肺门淋巴结转移,胃大弯有肿块,腹部有多个淋巴结转移。初次就诊 35 天后,患者出现呕吐和黑便症状加重。随访 CT 扫描显示小肠转移,导致继发性肠梗阻和肠套叠。
活检证实肺和胃的低分化腺癌,免疫组化支持肺腺癌的诊断。基因检测显示各种基因无突变或扩增。
患者接受了介入止血治疗,但疗效不佳。
患者胃肠道症状恶化。尽管进行了干预,但患者最终在就诊后 78 天死亡。
本文报告的肺癌转移至胃和小肠的病例具有高度侵袭性和快速进展性。结合文献报道,这种转移通常预示着患者预后不良。手术切除的长期获益尚不清楚,未来需要更多的病例和数据进行进一步分析。