Abstract
A 80-year-old male was admitted to our hospital because of abdominal pain and tarry stool. Chest X-ray film revealed a tumor shadow in the left lower lung field. And cytologic examination of sputum suggested squamous cell carcinoma of the lung. Moreover, roentogenography and endoscopy of the small intestine revealed protuberant lesion in 30 cm anal side of the ligament of Treitz. Biopsy specimen from this lesion did not show malignant findings. However, laparoscopic examination revealed a hens' egg-sized, white medullary and cauliflower-like tumor on the serosal surface of the small intestine. And biopsy specimen from this tumor showed squamous cell carcinoma. Based on this finding, a diagnosis of metastatic small intestinal carcinoma, secondary to the lung carcinoma was made. Operative findings revealed six metastatic intestinal carcinoma, consisting of 2 lesions in the jejunum, 2 lesions in the ileum and 2 lesions in the transverse colon. The incidence of metastatic small intestinal carcinoma, secondary to the lung carcinoma is few and making diagnosis for small intestinal lesion is difficult. Therefore, it is very rare to make a diagnosis before operation or autopsy like this case. In this case, laparoscopic examination was thought very useful for making a diagnosis.
