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原发性肺癌伴十二指肠转移并发性梗阻性黄疸和胰腺炎:一例报告

Primary lung cancer with duodenal metastasis complicated by obstructive jaundice and pancreatitis: a case report.

作者信息

Kuang Jie, Chen Yanan, Xie Huikang, Hao Hua, Zhao Yanlin, Tang Cui

机构信息

Department of Radiology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China.

Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.

出版信息

Front Oncol. 2025 Sep 12;15:1632696. doi: 10.3389/fonc.2025.1632696. eCollection 2025.

Abstract

BACKGROUND

Primary lung adenocarcinoma with duodenal metastasis is relatively rare, and its early clinical symptoms are often insidious, making diagnosis challenging. CT, MR, PET-CT, and gastroscopy can effectively identify gastrointestinal metastatic lesions, providing reliable evidence for definitive diagnosis and treatment planning, which contributes to prolonging patient survival.

CASE PRESENTATION

This report presents a rare case of duodenal metastasis from lung adenocarcinoma. The patient was diagnosed with lung adenocarcinoma (cT4N3M1c, stage IVb) one year prior. During chemotherapy, the patient gradually developed symptoms of abdominal distension and progressive jaundice. Through analysis of CT and MR imaging changes during the disease course, combined with laboratory test indicators, malignant duodenal tumor causing biliary obstruction and pancreatitis was suspected. Ultimately, endoscopic pathological biopsy confirmed duodenal metastasis from primary lung cancer. The clinical surgeon implemented a PTCD treatment plan, successfully relieving the patient's biliary obstruction.

CONCLUSIONS

Primary lung cancer patients presenting with abdominal symptoms and imaging findings suggestive of gastrointestinal tumors should be highly suspected of metastasis. Timely pathological diagnosis is essential to determine the nature and origin of the tumor, thereby facilitating the formulation of individualized treatment plans.

摘要

背景

原发性肺腺癌伴十二指肠转移相对罕见,其早期临床症状往往隐匿,诊断具有挑战性。CT、MR、PET-CT和胃镜检查可有效识别胃肠道转移病灶,为明确诊断和治疗方案制定提供可靠依据,有助于延长患者生存期。

病例介绍

本报告呈现了一例罕见的肺腺癌十二指肠转移病例。该患者一年前被诊断为肺腺癌(cT4N3M1c,IVb期)。化疗期间,患者逐渐出现腹胀和进行性黄疸症状。通过分析病程中的CT和MR影像变化,结合实验室检查指标,怀疑是恶性十二指肠肿瘤导致胆管梗阻和胰腺炎。最终,内镜病理活检证实为原发性肺癌十二指肠转移。临床外科医生实施了经皮肝穿胆道引流(PTCD)治疗方案,成功缓解了患者的胆管梗阻。

结论

出现腹部症状且影像学表现提示胃肠道肿瘤的原发性肺癌患者应高度怀疑转移。及时进行病理诊断对于确定肿瘤的性质和来源至关重要,从而有助于制定个体化治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a68/12463586/78d621ee1d34/fonc-15-1632696-g001.jpg

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