A 52-year-old male, who had been on follow-up for his multiple submucosal tumors of the stomach in other clinic since 1988, was referred to our department for further investigation of the tumors showing increase in size and number in August, 2000. The initial x-ray and endoscopic examinations of the gastrointestinal tract detected multiple gently sloping tumors in the stomach, small and large intestine. He, however, was found to have newly developed polypoid lesions in the stomach and cecum at gastroscopy and colonoscopy performed 4 months later than the initial examinations. Biopsy specimens taken from the newly developed lesion were reported as showing carcinoid tumor.
Soon after the examinations, he suddenly developed unconsciousness due to multiple metastatic tumors of the brain, and he died one month later. Autopsy disclosed a primary lung cancer of small cell type with muitiple secondary deposits in the stomach, small intestine and colon together with other organs. Retrospectively, newly developed polypoid lesions are endoscopically different from carcinoid tumor, which was reported as showing on the biopsied specimen by a pathologist.
There have been no reports on gastrointestinal lipomatosis co-existent with multiple foci of metastatic lung cancer. Careful analyses of endoscopic findings, however, are considerd to be extremely important to make a diagnosis even in very rare case.
