Small intestinal metastasis from pulmonary cancer diagnosed by capsule and balloon-assisted endoscopy

Abstract

Two cases of small intestinal metastasis from pulmonary cancer are reported.
Case 1 : A 64-year-old man was diagnosed with non-small-cell lung cancer in November 2011. First-line chemotherapy was ineffective, and in July 2012 the patient was admitted to the hospital with abdominal pain, hematemesis, hematochezia and anemia. Abdominal CT and capsule endoscopy were suggestive of an ulcerative tumor with bleeding in the jejunum. Partial jejunectomy was performed. Pathological diagnosis was small intestinal metastasis from the pulmonary cancer. The patient could eat and his anemia was controlled until he died seven months post-surgery.
Case 2 : A 46-year-old man received surgery for treatment of a large cell carcinoma of the right lung in February 2012. He was admitted to the hospital in July 2012 with anorexia, abdominal pain and dyschezia. Abdominal CT showed an enhanced tumor in the ileum. Single-balloon assisted endoscopy revealed an ulcerative tumor. Pathological findings based on the biopsy specimen were compatible with small intestinal metastasis from the pulmonary cancer. After palliative ilectomy, the patient’s symptoms were controlled. He received second-line and third-line chemotherapies, until peritoneal metastasis progressed and he died four months after ilectomy.