A case of lung cancer metastasized to the gastrointestinal anastomosis site where the primary gastric cancer was resected 17 years ago
Introduction
Lung cancer is the leading cause of death from cancer world-wide. Metastatic spread of lung cancer may involve any organ, but metastases to the gastrointestinal tract, particularly to the duodenum, are considered unusual [1], [2], [3], [4], [5]. Although usually asymptomatic, gastrointestinal metastases may induce perforation, obstruction, or, rarely, bleeding [6]. Patients with small intestinal metastases secondary to lung cancer have poor prognoses and do not typically live longer than 16 weeks [2].
In this report, we for the first time report an extremely rare case of a patient who developed a metastatic adenocarcinoma at the anastomosis site, where gastroduodenostomy was performed for gastric adenocarcinoma at 17 years ago, secondary to the lung cancer.
Section snippets
Case report
A 76-year-old man, 17 years status post a Billroth I gastroduodenostomy for gastric adenocarcinoma and without a history of smoking or alcohol abuse, injured himself in a fall, fracturing his right femoral shaft. On admission, a chest X-ray showed a nodular opacity in the left apical lung. The patient underwent a wide excision and closed reduction and internal fixation of the femoral fracture. Pathologic examination of the fracture revealed metastatic carcinoma. Immunohistochemistry was
Discussion
Here we for the first time report an interesting case of the lung cancer metastasized to the gastrointestinal site or location where a first primary cancer was once resected 17 years ago. Primary lung cancer is often asymptomatic, and about 50% of patients with lung cancer have metastases on diagnosis [7]. Lung cancer typically metastasizes to the adrenal glands, bone, liver, brain, and kidneys, only infrequently to the digestive system [8]. Small bowel metastases, which usually originate from
Conflict of interest statement
The authors declare no conflict of interest.
Funding
None.
Acknowledgment
We thank Wen-Chiuan Tsai for editorial assistance.
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