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探索肺腺癌胃肠道转移的多方面挑战:一例突出诊断困境与治疗创新的病例报告

Exploring the multifaceted challenges of gastrointestinal metastases in lung adenocarcinoma: a case report highlighting diagnostic dilemmas and therapeutic innovations.

作者信息

Xu Xinxin, Zhou Qian, Chen Peng, Du Chengzhou, Huang Yonghua, Gao Xiaoxin, Xu Shumei, Wu Jinling, He Tianxiao, Li Hongtao

机构信息

Department of General Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, Gansu, China.

Department of General Surgery, The Second Clinical Medical School of Lanzhou University, Lanzhou, Gansu, China.

出版信息

Front Oncol. 2024 Nov 26;14:1486371. doi: 10.3389/fonc.2024.1486371. eCollection 2024.

Abstract

BACKGROUND

Lung cancer, the primary cause of cancer-related deaths, often metastasizes early, commonly affecting the liver, brain, bones, and adrenal glands. Although gastrointestinal (GI) metastasis is rare, it poses significant diagnostic and therapeutic challenges and is frequently linked to severe complications.

CASE DESCRIPTION

We present a case of a 61-year-old male with a history of lung cancer who presented with intestinal obstruction. The initial diagnosis of poorly differentiated adenocarcinoma was confirmed by computed tomography (CT) and bronchoscopic biopsy. The patient underwent chemotherapy, after which he developed intestinal obstruction. Further imaging and histopathological analysis indicated GI metastasis. Despite treatment with both chemotherapy and immunotherapy, the patient experienced recurrent obstruction, necessitating surgical intervention. Postoperatively, he had another episode of perforation, which was addressed with an emergency laparotomy, revealing metastatic adenocarcinoma at the site of perforation.

CONCLUSIONS

This case highlights the complexities in diagnosing and treating GI metastases from lung cancer. It underscores the necessity for multimodal treatment strategies and underscores the urgent need for research focused on early detection methods to improve patient outcomes.

摘要

背景

肺癌是癌症相关死亡的主要原因,常早期发生转移,常见转移部位包括肝脏、脑、骨骼和肾上腺。尽管胃肠道转移罕见,但它带来了重大的诊断和治疗挑战,且常与严重并发症相关。

病例描述

我们报告一例61岁男性肺癌患者,该患者出现肠梗阻。计算机断层扫描(CT)和支气管镜活检确诊为低分化腺癌。患者接受了化疗,之后出现肠梗阻。进一步的影像学和组织病理学分析表明存在胃肠道转移。尽管接受了化疗和免疫治疗,患者仍反复出现梗阻,需要手术干预。术后,他又发生了一次穿孔,通过急诊剖腹手术处理,在穿孔部位发现转移性腺癌。

结论

该病例突出了肺癌胃肠道转移诊断和治疗的复杂性。强调了多模式治疗策略的必要性,并强调迫切需要开展专注于早期检测方法的研究以改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ca5/11628370/bf7f6f1abb1a/fonc-14-1486371-g001.jpg

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