Abstract
A 58-year-old man was found to have an abnormal shadow on chest X-ray. On chest computed tomography, a 10 cm-sized tumor was seen in at the upper lobe of the right lung ; the tumor had directly invaded into the chest wall. On cytological and histological examinations a pulmonary carcinoma cT3N0M0, StageIIB was diagnosed. The patient had a right upper lobectomy with resection of the third and fourth ribs as well as a node dissection. Although components of squamous cell carcinoma and adenocarcinoma were seen to coexist on microscopy, immunohistochemistry confirmed the presence of a poorly differentiated adenocarcinoma. The final stage was T3N2M0, stageIIIA. Despite postoperative chemotherapy, a brain metastasis was found seven months after surgery ; the brain tumor was extirpated, and radiation therapy was given. Carcinomatous pleuritis and mediastinal lymph node swelling appeared 10 months after the initial surgery. A bowel obstruction also occurred ; intussusception due to intestinal tumor was suspected bosed on abdominal ultrasonography and computed tomography results. The patient had a laparotomy, and a diagnosis of intussusception due to jejunal tumor was confirmed. The ileum was resected. On histopathology, the intestinal tumor was diagnosed as a lung cancer metastasis. The patient died on the thirteenth postoperative day. We report a case of intussusception due to lung cancer metastasis to the small intestine and review the relevant Japanese literature.
