Laparoscopic small bowel resection of metastatic pulmonary carcinosarcoma

Gastrointestinal hemorrhage due to ileal metastasis from primary lung cancer

We report a patient with small intestinal metastasis from lung squamous cell carcinoma. A 66-year-old man who underwent radical lung cancer surgery was admitted to our hospital. Before starting his fifth cycle of chemotherapy, he was found to have a positive fecal occult blood test. Abdominal computed tomography scan revealed an ileal tumor with mesenteric lymph node enlargement. He underwent laparoscopic resection of the involved small intestine and mesentery. Histopathological analysis confirmed metastasis from lung cancer. We conducted a review of the literature and 64 documented cases of small intestinal metastasis from lung cancer were found. The pathologic diagnosis, clinical presentation, site of metastasis, and survival time in these cases were reviewed.

Ileal metastasis of pulmonary sarcomatoid carcinoma with hemorrhagic necrosis: A case report

Pulmonary sarcomatoid carcinoma (PSC) is a rare clinical entity, and small intestine metastases of PSC are even rarer. Here we report a case of ileal metastasis of PSC with hemorrhage and necrosis. The surgeon should raise their awareness of this rare tumor. Lung cancer can transfer to various tissues and organs, and digestive tract metastases of lung cancer are not rare. Clinical manifestations of PSC are not specific, and small intestine metastases of PSC can cause intestinal obstruction, intussusceptions, intestinal necrosis and perforation.

Small bowel intussusception due to metastatic intestinal carcinosarcoma from a pulmonary primary

Metastatic small bowel tumors are rarely encountered. They usually present with small bowel obstruction, perforation, bleeding, or, rarely, intestinal intussusception. Only a few case reports have mentioned bowel symptoms due to metastatic malignancies. We report a seldom encountered clinical condition of intestinal intussusception from metastatic lung malignancy. Pathology demonstrated both epithelial and mesenchymal content, and the final diagnosis was carcinosarcoma. This case report indicates that intestinal metastases should be considered in the differential diagnosis for patients with lung malignancy and abdominal symptoms.

Best resident poster award: evaluation of anastomotic techniques for laparoscopic resection of isolated small intestine pathology

BACKGROUND

The purpose of this study was to compare perioperative outcomes for intracorporeal versus extracorporeal anastomotic techniques for isolated laparoscopic small-intestine resection.

METHODS

A retrospective database was created for all adult patients who underwent a laparoscopic segmental small-intestine resection. Patients with inflammatory bowel disease or requiring an ileocolectomy were excluded.

RESULTS

Laparoscopic resection was performed in 52 patients (ratio of men:women, 30:22) with a mean age of 47 ± 21 years. A laparoscopic intracorporeal anastomosis was performed in 30 patients (58%), and an extracorporeal anastomosis was performed in 22 patients (42%). There was no difference in mean operating room time, estimated blood loss, perioperative complication rate, or length of stay between the 2 groups. Ten patients had a complication, and 5 patients experienced a Clavien grade II or greater complication.

CONCLUSIONS

Laparoscopic segmental small-bowel resection using either intracorporeal or extracorporeal anastomotic techniques is equally efficacious for pathology isolated to the small bowel.

Lung carcinosarcoma

Lung carcinosarcoma is a neoplasm of high grade composed of epithelial and mesenchymal cells. It is exceptional; and usually affects men who are smokers, between the fifth and eighth decades of life. Medical treatment, chemotherapy and radiotherapy are not active in this kind of tumour, so surgery is the treatment of choice. Prognosis is poor with survival rates at 6 months around 27%. We describe the diagnostic process and the clinical outcome of a patient with lung carcinosarcoma with several paraneoplastic syndromes.

Frequency, symptoms and outcome of intestinal metastases of bronchopulmonary cancer. Case report and review of the literature

BACKGROUND

We report a new case of small bowel metastases from primary lung cancer. Such metastases are not exceptional, but their clinical manifestations are rare.

CASE PRESENTATION

The case involved a 56-year-old man with a squamous cell carcinoma of the lung (stage IV) that had been treated with chemotherapy. He presented fourteen months after diagnosis with an acute abdominal pain. Abdominal CT-scan demonstrated a perforated jejunum and he underwent emergency surgery. Postoperative pathologic analysis confirmed the diagnosis of metastatic pulmonary carcinoma. The patient was discharged after ten days, but died 8 weeks after surgery at home on tumor progression.

CONCLUSION

We were able to find 58 documented similar cases in the literature. Most cases presented with bowel perforation or obstruction. Squamous cell carcinoma was the most common histological cell type followed by large cell carcinoma. Other metastases are often present, and the prognosis is mostly fatal at short term.