Abstract
A 46-year-old male was diagnosed as having right lung cancer and underwent right pneumonectomy and lymph node dissection. Although the histological diagnosis was poorly differentiated adenocarcinoma, large cell carcinoma was also observed. After the surgery, the patient complained of epigastralgia, and gastrofiberscopy showed an elevated lesion whose top was slightly depressed on the greater curvature of the lower body of the stomach. A specimen obtained by endoscopic mucosal resection showed poorly differentiated tumor cells. Two months after pneumonectomy, laparotomy was done on suspicion of stomach metastasis. Surgical findings showed another tumor in the jejunum, so gastrectomy and partial resection of the small intestine were performed. Histological diagnosis was metastases to the stomach and small intestine from lung cancer, because large cell carcinoma was observed mainly deeper than the submucosa. Two months after gastrectomy, brain metastasis was revealed, and then bone and hepatic metastases were detected, and he died at 8 months after pneumonectomy.
Although lung cancer with gastrointestinal tract metastasis is rare, its prognosis is poor, so it is important to determine the treatment strategy carefully.
