Guo Kunliang, Li Yang, Chen Jian
Department of Cardiothoracic Surgery, Anqing Municipal Hospital, Anqing, China.
Department of Pathology, Anqing Municipal Hospital, Anqing, China.
Open Life Sci. 2025 Aug 18;20(1):20251149. doi: 10.1515/biol-2025-1149. eCollection 2025.
This report presents a case of solitary pulmonary metastasis from colon cancer, characterized by cystic airspaces, which can mimic a second primary lung cancer (LC). Preoperative contrast-enhanced computed tomography in a patient with colon cancer revealed a pulmonary micronodule with a cystic cavity in the right upper lobe. The patient subsequently underwent left-sided hemicolectomy followed by six cycles of chemotherapy. During follow-up, computed tomography demonstrated resolution of the right upper lobe nodule. However, 36 months after chemotherapy, a solid nodule with cystic airspaces appeared in the right upper lobe, exhibiting marginal spiculation, traversing vessels, and enhancement, suggestive of cystic LC. Intraoperative frozen section analysis indicated features of intestinal adenocarcinoma. A right upper lobe wedge resection was performed, and postoperative histopathology confirmed the lesion as metastatic colon adenocarcinoma with cystic airspaces. Solitary pulmonary metastasis from colon cancer is relatively uncommon, particularly with cystic presentation. Clinicians and radiologists should maintain heightened suspicion in such atypical cases to avoid missed or delayed diagnoses.
本报告介绍了一例结肠癌孤立性肺转移病例，其特征为囊性气腔，可酷似第二原发性肺癌（LC）。一名结肠癌患者的术前增强计算机断层扫描显示右上叶有一个带有囊性腔的肺微结节。该患者随后接受了左侧半结肠切除术，随后进行了六个周期的化疗。在随访期间，计算机断层扫描显示右上叶结节消失。然而，化疗36个月后，右上叶出现一个带有囊性气腔的实性结节，表现为边缘毛刺、血管穿行和强化，提示为囊性LC。术中冰冻切片分析显示为肠腺癌特征。进行了右上叶楔形切除术，术后组织病理学证实该病变为伴有囊性气腔的转移性结肠腺癌。结肠癌的孤立性肺转移相对少见，尤其是呈囊性表现时。临床医生和放射科医生对此类非典型病例应保持高度怀疑，以避免漏诊或延误诊断。
