Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena

Xiaofang Ying, Mingwei Wang, Vivek Verma, Manxiang Wang, Shengwei Ye, Jianping Bi, Xiaoyi Zhou, Guang Han, Weining Zhen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Rationale: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. Patient concerns: Clinical data and treatment of a 59-year-old man with small intestine metastasis from primary solid subtype lung adenocarcinoma are summarized. Diagnoses: A man who was previously diagnosed with stage IIIA (T3N2M0) lung adenocarcinoma (solid subtype) came to our hospital for postoperative radiotherapy. Laboratory tests indicated anemia and melena. The patient was initially believed to have digestive ulcer and was treated with omeprazole, which proved to be ineffective. We conducted an abdominal computed tomography (CT) contrast scan and discovered a mass in the small intestine mass. Further positron emission tomography-computed tomography (PET-CT) imaging indicated the small intestine mass with fluorodeoxyglucose uptake. Interventions: The patient underwent an enterectomy and anastomosis. Pathological analysis confirmed the diagnosis of small intestinal metastasis from lung cancer with concomitant mesenteric lymph node metastasis. Outcomes: One month after the operation, hemoglobin levels became normal, and the patient had good quality of life. However, 3 months after the operation, the patient suffered from anemia again. An abdominal CT scan indicated a new small intestine mass. Progression continued rapidly, and the patient died of hemorrhagic shock 5.5 months after the resection of the small intestine mass. Lessons: Although uncommon, if lung cancer patients present with anemia and melena, enteric metastasis should be part of the differential diagnosis. Abdominal CT scans and PET-CT are effective for early diagnosis. The prognosis of metastatic spread of solid subtype lung adenocarcinoma to the small intestine with mesenteric lymph node metastasis is poor. Subgroups of patients benefitting from metastasectomy and more effective systemic therapy need to be further investigated.

Original languageEnglish (US)
Article numbere7768
JournalMedicine (United States)
Volume96
Issue number34
DOIs
StatePublished - Aug 1 2017

Fingerprint

Melena
Small Intestine
Anemia
Neoplasm Metastasis
Lung Neoplasms
Tomography
Early Diagnosis
Lymph Nodes
Metastasectomy
Omeprazole
Hemorrhagic Shock
Adenocarcinoma of lung
Ulcer
Hemoglobins
Differential Diagnosis
Radiotherapy
Quality of Life
Incidence

Keywords

  • anemia
  • lung adenocarcinoma
  • metastasis
  • small intestine
  • solid subtype

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena. / Ying, Xiaofang; Wang, Mingwei; Verma, Vivek; Wang, Manxiang; Ye, Shengwei; Bi, Jianping; Zhou, Xiaoyi; Han, Guang; Zhen, Weining.

In: Medicine (United States), Vol. 96, No. 34, e7768, 01.08.2017.

Research output: Contribution to journalArticle

Ying, Xiaofang ; Wang, Mingwei ; Verma, Vivek ; Wang, Manxiang ; Ye, Shengwei ; Bi, Jianping ; Zhou, Xiaoyi ; Han, Guang ; Zhen, Weining. / Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena. In: Medicine (United States). 2017 ; Vol. 96, No. 34.
@article{565a4fa8f57e44079b478fe5bbd9a9a0,
title = "Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena",
abstract = "Rationale: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. Patient concerns: Clinical data and treatment of a 59-year-old man with small intestine metastasis from primary solid subtype lung adenocarcinoma are summarized. Diagnoses: A man who was previously diagnosed with stage IIIA (T3N2M0) lung adenocarcinoma (solid subtype) came to our hospital for postoperative radiotherapy. Laboratory tests indicated anemia and melena. The patient was initially believed to have digestive ulcer and was treated with omeprazole, which proved to be ineffective. We conducted an abdominal computed tomography (CT) contrast scan and discovered a mass in the small intestine mass. Further positron emission tomography-computed tomography (PET-CT) imaging indicated the small intestine mass with fluorodeoxyglucose uptake. Interventions: The patient underwent an enterectomy and anastomosis. Pathological analysis confirmed the diagnosis of small intestinal metastasis from lung cancer with concomitant mesenteric lymph node metastasis. Outcomes: One month after the operation, hemoglobin levels became normal, and the patient had good quality of life. However, 3 months after the operation, the patient suffered from anemia again. An abdominal CT scan indicated a new small intestine mass. Progression continued rapidly, and the patient died of hemorrhagic shock 5.5 months after the resection of the small intestine mass. Lessons: Although uncommon, if lung cancer patients present with anemia and melena, enteric metastasis should be part of the differential diagnosis. Abdominal CT scans and PET-CT are effective for early diagnosis. The prognosis of metastatic spread of solid subtype lung adenocarcinoma to the small intestine with mesenteric lymph node metastasis is poor. Subgroups of patients benefitting from metastasectomy and more effective systemic therapy need to be further investigated.",
keywords = "anemia, lung adenocarcinoma, metastasis, small intestine, solid subtype",
author = "Xiaofang Ying and Mingwei Wang and Vivek Verma and Manxiang Wang and Shengwei Ye and Jianping Bi and Xiaoyi Zhou and Guang Han and Weining Zhen",
year = "2017",
month = "8",
day = "1",
doi = "10.1097/MD.0000000000007768",
language = "English (US)",
volume = "96",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "34",

}

TY - JOUR

T1 - Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena

AU - Ying, Xiaofang

AU - Wang, Mingwei

AU - Verma, Vivek

AU - Wang, Manxiang

AU - Ye, Shengwei

AU - Bi, Jianping

AU - Zhou, Xiaoyi

AU - Han, Guang

AU - Zhen, Weining

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Rationale: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. Patient concerns: Clinical data and treatment of a 59-year-old man with small intestine metastasis from primary solid subtype lung adenocarcinoma are summarized. Diagnoses: A man who was previously diagnosed with stage IIIA (T3N2M0) lung adenocarcinoma (solid subtype) came to our hospital for postoperative radiotherapy. Laboratory tests indicated anemia and melena. The patient was initially believed to have digestive ulcer and was treated with omeprazole, which proved to be ineffective. We conducted an abdominal computed tomography (CT) contrast scan and discovered a mass in the small intestine mass. Further positron emission tomography-computed tomography (PET-CT) imaging indicated the small intestine mass with fluorodeoxyglucose uptake. Interventions: The patient underwent an enterectomy and anastomosis. Pathological analysis confirmed the diagnosis of small intestinal metastasis from lung cancer with concomitant mesenteric lymph node metastasis. Outcomes: One month after the operation, hemoglobin levels became normal, and the patient had good quality of life. However, 3 months after the operation, the patient suffered from anemia again. An abdominal CT scan indicated a new small intestine mass. Progression continued rapidly, and the patient died of hemorrhagic shock 5.5 months after the resection of the small intestine mass. Lessons: Although uncommon, if lung cancer patients present with anemia and melena, enteric metastasis should be part of the differential diagnosis. Abdominal CT scans and PET-CT are effective for early diagnosis. The prognosis of metastatic spread of solid subtype lung adenocarcinoma to the small intestine with mesenteric lymph node metastasis is poor. Subgroups of patients benefitting from metastasectomy and more effective systemic therapy need to be further investigated.

AB - Rationale: Metastasis to the small intestine from a primary lung cancer is rare, and is associated with a poor prognosis. Early diagnosis of small intestine metastasis is difficult because of the low incidence of clinically apparent symptoms. Patient concerns: Clinical data and treatment of a 59-year-old man with small intestine metastasis from primary solid subtype lung adenocarcinoma are summarized. Diagnoses: A man who was previously diagnosed with stage IIIA (T3N2M0) lung adenocarcinoma (solid subtype) came to our hospital for postoperative radiotherapy. Laboratory tests indicated anemia and melena. The patient was initially believed to have digestive ulcer and was treated with omeprazole, which proved to be ineffective. We conducted an abdominal computed tomography (CT) contrast scan and discovered a mass in the small intestine mass. Further positron emission tomography-computed tomography (PET-CT) imaging indicated the small intestine mass with fluorodeoxyglucose uptake. Interventions: The patient underwent an enterectomy and anastomosis. Pathological analysis confirmed the diagnosis of small intestinal metastasis from lung cancer with concomitant mesenteric lymph node metastasis. Outcomes: One month after the operation, hemoglobin levels became normal, and the patient had good quality of life. However, 3 months after the operation, the patient suffered from anemia again. An abdominal CT scan indicated a new small intestine mass. Progression continued rapidly, and the patient died of hemorrhagic shock 5.5 months after the resection of the small intestine mass. Lessons: Although uncommon, if lung cancer patients present with anemia and melena, enteric metastasis should be part of the differential diagnosis. Abdominal CT scans and PET-CT are effective for early diagnosis. The prognosis of metastatic spread of solid subtype lung adenocarcinoma to the small intestine with mesenteric lymph node metastasis is poor. Subgroups of patients benefitting from metastasectomy and more effective systemic therapy need to be further investigated.

KW - anemia

KW - lung adenocarcinoma

KW - metastasis

KW - small intestine

KW - solid subtype

UR - http://www.scopus.com/inward/record.url?scp=85028717808&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028717808&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000007768

DO - 10.1097/MD.0000000000007768

M3 - Article

C2 - 28834880

AN - SCOPUS:85028717808

VL - 96

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 34

M1 - e7768

ER -