Shimada Ayako, Ohnaka Shinnosuke, Nakashima Masanao, Nagai Atsushi
Department of Respiratory Medicine, Shin-Yurigaoka General Hospital, Kanagawa, JPN.
Cureus. 2024 Dec 17;16(12):e75909. doi: 10.7759/cureus.75909. eCollection 2024 Dec.
Gastrointestinal (GI) metastases from lung cancer are relatively rare, and their management strategies and outcomes in the era of immune checkpoint inhibitors are unknown. A 59-year-old man with lung cancer was hospitalized. He presented with vomiting due to a small intestinal metastasis. The metastatic lesion reduced in size with pembrolizumab treatment. However, the patient could not feed orally and required continuous central venous nutrition. Following the recurrence of a catheter-related bloodstream infection, the patient underwent small intestinal resection and gastrojejunal bypass surgery. Surgical specimens from the site of intestinal stenosis showed tumor disappearance and inflammatory cell invasion. GI stenosis due to lung cancer metastasis can persist even after effective treatment with immune checkpoint inhibitors. Therefore, surgery for GI metastases should be considered as necessary.
肺癌的胃肠道转移相对少见，在免疫检查点抑制剂时代，其治疗策略及预后尚不清楚。一名59岁肺癌男性患者住院。他因小肠转移出现呕吐症状。经帕博利珠单抗治疗后，转移灶缩小。然而，患者无法经口进食，需要持续中心静脉营养。在发生与导管相关的血流感染复发后，患者接受了小肠切除及胃空肠吻合术。小肠狭窄部位的手术标本显示肿瘤消失及炎性细胞浸润。即使在免疫检查点抑制剂有效治疗后，肺癌转移所致的胃肠道狭窄仍可能持续存在。因此，必要时应考虑对胃肠道转移灶进行手术治疗。
