Abstract
Background. Small bowel metastases from primary lung cancer are rare. Case 1. A 61-year-old man was given a diagnosis of lung cancer recurrence (non-small cell lung cancer) 3 months after a lobectomy. He complained of acute abdomen during the chemotherapy. Radiographic examination revealed free air below the right diaphragm. Gastrointestinal perforation was diagnosed. Despite ileum resection, he died of sepsis 3 days postoperatively. Pathological examination of the resected ileum demonstrated a metastatic type 2 tumor with perforation. Case 2. A 72-year-old man was given a diagnosis of lung cancer (non-small cell lung cancer) in stage IV. He complained of acute abdomen with massive gastrointestinal bleeding during chemotherapy. He underwent ileum resection for refractory melena. Pathology of the resected ileum showed a metastatic type 2 tumor with a large ulcer. He died of disease progression of lung cancer 1 month after the operation. Conclusion. To achieve an early diagnosis and treatment of acute abdomen in patients with primary lung cancer, FDG-PET, PET-CT and/or endoscopic examination should be performed for the screening of gastrointestinal metastasis.
