Abstract
The patient was an 81-year-old women who was diagnosed as having adenocarcinoma of the left lower lobe of the lung (cT3N2M1 Stage IV) in April 2008. She was followed up without any treatment, because she rejected chemotherapy. In June, she was admitted for radiation therapy for right acetabular metastasis. Lower abdominal pain suddenly occurred 14 days after admission. Abdominal computed tomography examination showed free air in the abdominal cavity. She was diagnosed as having perforating peritonitis and underwent an emergency operation. During the operation, a perforated ileum was observed, and partial resection of the intestine was performed. The pathologic diagnosis of the resected specimen was metastasis of lung cancer to the small intestine. She was able to eat after the operation, however, the pulmonary lesion progressed, the patient's general condition deteriorated, and the patient died on the 81st postoperative day. Metastasis to the small intestine from lung cancer is rare, and the prognosis of peritonitis due to perforated intestinal metastasis from lung cancer is poor. It should however be considered when progressive abdominal symptoms are observed in patients with lung cancer.
