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Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: A case report.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834880
OWN - NLM
STAT- In-Process
DA  - 20170823
LR  - 20170823
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Metastatic spread of solid subtype lung adenocarcinoma to the small intestine
      with anemia and melena: A case report.
PG  - e7768
LID - 10.1097/MD.0000000000007768 [doi]
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.
FAU - Ying, Xiaofang
AU  - Ying X
AD  - aDepartment of Radiation Oncology bDepartment of Pathology, Hubei Cancer Hospital
      cDepartment of Radiation Oncology, University of Nebraska Medical Centre, Omaha, 
      NE dDepartment of Gastrointestinal Surgery, Hubei Cancer Hospital eDepartment of 
      Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
FAU - Wang, Mingwei
AU  - Wang M
FAU - Verma, Vivek
AU  - Verma V
FAU - Wang, Manxiang
AU  - Wang M
FAU - Ye, Shengwei
AU  - Ye S
FAU - Bi, Jianping
AU  - Bi J
FAU - Zhou, Xiaoyi
AU  - Zhou X
FAU - Han, Guang
AU  - Han G
FAU - Zhen, Weining
AU  - Zhen W
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/08/24 06:00
MHDA- 2017/08/24 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007768 [doi]
AID - 00005792-201708250-00017 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7768. doi: 10.1097/MD.0000000000007768.