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Ibrahimli A, Aliyev A, Majidli A, Kahraman A, Galandarova A, Khalilzade E, Mammadli H, Huseynli K, Assaf K, Kilinc C, Muradov N, Alisan OF, Abdullayev S, Sahin YI, Samadov E. Metastasis to the stomach: a systematic review. F1000Res 2023; 12:1374. [PMID: 38706640 PMCID: PMC11066534 DOI: 10.12688/f1000research.140758.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 05/07/2024] Open
Abstract
Background: This study reviews the literature on gastric metastases (GM) in terms of diagnosis, treatment, and outcomes. The goal of this study was to provide clinicians with a reliable and beneficial source to understand gastric metastases arising from various primary tumors and to present the growing literature in an easily accessible form. Methods: Articles published in English language from implementation of MEDLINE and Cochrane databases until May 2022 were considered for the systematic review. Articles other than English language, letters to the editor, posters, and clinical images were excluded. Hematogenous and lymphogenic metastases were included whereas direct tumoral invasion and seeding were excluded. Articles and abstracts were analyzed and last selection was done after cross-referencing and by use of defined eligibility criteria. Results: In total 1,521 publications were identified and 170 articles were finally included totaling 186 patients with GM. The median age of patients was 62 years. Gynecologic cancer was the most common cancer type causing GM (67 patients), followed by lung cancer (33 patients), renal cancer (20 patients), and melanoma (19 patients). One of the main treatment methods performed for metastasis was resection surgery (n=62), sometimes combined with chemotherapy (ChT) or immunotherapy. ChT was the other most used treatment method (n=78). Also, immunotherapy was amongst the most preferred treatment options after surgery and ChT (n=10). Conclusions: As 172 case reports were screened in the systematic review from different journals, heterogeneity was inevitable. Some articles missed important information such as complete follow-up or clinical information. Moreover, since all of the included articles were case reports quality assessment could not be performed. Among 172 case reports reviewed, resection surgery was performed the most and was sometimes combined with ChT and immunotherapy. Further research about what type of treatment has the best outcomes for patients with gastric metastases is needed.
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Wang M, Zhang W, Fu C, Guan J, Ni X, Yao F. Endoscopic manifestations and treatment outcomes of asymptomatic gastric metastases from primary lung adenocarcinoma: Report of two cases. Oncol Lett 2023; 25:228. [PMID: 37153059 PMCID: PMC10157602 DOI: 10.3892/ol.2023.13814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/16/2023] [Indexed: 05/09/2023] Open
Abstract
Metastatic spread of lung adenocarcinoma to the stomach is rare and most gastric metastases are discovered at the advanced stage due to certain symptoms. The present study reported two cases of asymptomatic gastric metastases from lung adenocarcinoma presenting as diminutive nodules or erosion endoscopically. The manifestations were also visualized under magnifying endoscopy with blue laser imaging (BLI-ME), the two cases share certain common characteristics under BLI-ME, such as an obviously widened intervening part and extended subepithelial capillary network, which indicated that lesions developed beneath the superficial epithelium. Target biopsy and further immunohistochemical staining confirmed that the gastric lesions were metastatic from primary lung cancer. None of the two patients were candidates for surgery due to multiple distant metastases, but the gastric metastases regressed to scars after systemic anticancer therapy. These two cases were presented in order to improve the current understanding of the endoscopic manifestations of early gastric metastases from lung cancer, and the outcomes may demonstrate that systemic treatment is effective for eliminating early gastric metastatic lesions.
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Affiliation(s)
- Meiling Wang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Wei Zhang
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Chunmei Fu
- Department of Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Jian Guan
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, P.R. China
| | - Xiaoguang Ni
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, P.R. China
- Correspondence to: Professor Fang Yao and Professor Xiaoguang Ni, Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 117 Panjiayuan Nanli, Chaoyang, Beijing 100020, P.R. China, E-mail:
| | - Fang Yao
- Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, P.R. China
- Correspondence to: Professor Fang Yao and Professor Xiaoguang Ni, Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 117 Panjiayuan Nanli, Chaoyang, Beijing 100020, P.R. China, E-mail:
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3
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Tang D, Lv J, Liu Z, Zhan S, Gao Y. Gastric Metastasis of Primary Lung Cancer: Case Report and Systematic Review With Pooled Analysis. Front Oncol 2022; 12:922016. [PMID: 35875072 PMCID: PMC9304872 DOI: 10.3389/fonc.2022.922016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/07/2022] [Indexed: 01/30/2023] Open
Abstract
BackgroundGastric metastasis from lung cancer (GMLC) is a rare occurrence. The clinicopathological characteristics, outcomes, and prognostic factors remain largely elusive.MethodsWe conducted a systematic review on case reports and case series of GMLC by scanning MEDLINE, Embase, and ISI Web of Knowledge. Data involving the clinicopathological features, treatment, and outcomes were extracted and analyzed. Survival analysis was performed using Kaplan–Meier method. The Cox proportional hazards regression model was used to identify potential prognostic factors associated with survival. Furthermore, a case of metastatic gastric adenocarcinoma of pulmonary origin with epidermal growth factor receptor (EGFR) L858R+T790M mutation was also described and included.ResultsSeventy-eight records involving 114 cases (including ours) were finally included. The median age on admission was 65 years with a male predominance of 79.8%. Lung adenocarcinoma (42.1%), located in the right upper lobe (30.3%), was the most frequent primary tumor. Bleeding (36.7%) and abdominal pain (35.8%) were the two most common symptoms. Endoscopically, gastric lesions were typically presented as elevated lesions with or without volcano-like ulceration, or ulcerative lesions, mostly involving the gastric corpus. The median overall survival time and survival time after diagnosis of metastatic cancer were 11 months [95% confidence interval (CI): 7–14] and 4.5 months (95% CI: 3–9), respectively. The survival analyses revealed that surgical interventions (including lung surgery and/or abdominal surgery) and systemic therapy (including chemotherapy, radiotherapy, and/or targeted therapy) seemed to be positive prognostic factors for both overall survival and survival after diagnosis of metastatic cancer.ConclusionsClinicians should be alerted to the occurrence of gastric metastasis in lung cancer patients. Comprehensive evaluation and appropriate treatment for specific patients may improve the survival rate of GMLC patients.
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Affiliation(s)
- Dong Tang
- Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Jianjian Lv
- Department of Oncology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Zhijing Liu
- Department of Pathology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Shuhui Zhan
- Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
| | - Yuqiang Gao
- Department of Gastroenterology, Qingdao Municipal Hospital, The Affiliated Municipal Hospital of Qingdao University, Qingdao, China
- *Correspondence: Yuqiang Gao,
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Liu J, Xia L, Peng Y, Huang YS, Yang ZZ. Gastric metastasis and transformation of primary lung adenocarcinoma to small cell cancer after acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors: A case report. Medicine (Baltimore) 2021; 100:e27289. [PMID: 34596125 PMCID: PMC8483845 DOI: 10.1097/md.0000000000027289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/19/2021] [Accepted: 09/02/2021] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Transformation to small cell lung cancer (SCLC) is one of the mechanisms of resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). However, no standard treatment is available after the transformation. In addition, gastric metastasis of primary lung cancer is rarely observed; thus, little is known about its metastatic characteristics. PATIENT CONCERNS A 58-year-old male patient was treated with gefitinib (0.25 g /day) as the 1st line treatment due of recurrence after surgical resection for EGFR exon 19 mutation pulmonary adenocarcinoma. However, he experienced recurrence with positive T790 M, and osimertinib (80 mg/day) was administered as the 2nd line therapy. DIAGNOSIS One year and 6 months after osimertinib initiation, he complained of stomachache, and a diagnostic gastroscopy biopsy confirmed small cell lung cancer in the gastric body, indicating osimertinib-induced phenotypic transformation. INTERVENTIONS AND OUTCOMES The patient was treated with etoposide and platinum chemotherapy and maintenance therapy with osimertinib. Finally, the patient achieved a partial response after 4 cycles. LESSONS Timely second biopsies should be considered in the diagnosis of phenotypic transformation. After transformation, chemotherapeutic treatment with etoposide and platinum and maintenance therapy with osimertinib inhibited the progression of the disease.
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Hu Y, Feit N, Huang Y, Xu W, Zheng S, Li X. Gastrointestinal metastasis of primary lung cancer: An analysis of 366 cases. Oncol Lett 2018; 15:9766-9776. [PMID: 29928351 PMCID: PMC6004691 DOI: 10.3892/ol.2018.8575] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 09/01/2017] [Indexed: 02/06/2023] Open
Abstract
The gastrointestinal (GI) tract is not a common site of metastasis in primary lung cancer. The aim of the present study was to reveal the clinical and prognostic characteristics of gastrointestinal metastases of lung cancer (GMLC). Information on 366 cases of GMLC was collected and factors that affect severe GI complications were analyzed. Univariate and multivariate survival analyses were performed using the Cox proportional hazards model. Of the cases analyzed, the small intestine (59.6%) and colorectum (25.6%) were the two organs where lung cancer was most likely to metastasize in the GI tract. Squamous cell carcinoma (28.5%), adenocarcinoma (27.6%) and large cell carcinoma (20.9%) were the three most common histological types. However, compared with the histological distributions of primary lung cancer, patients with large cell carcinoma exhibited the highest elevated risk of GMLC [relative risk (RR), 4.07; P<0.001] and those with adenocarcinoma exhibited the lowest risk (RR, 0.58; P<0.001). Differences in organ involvement and in histological type led to varying GI complications. It was also indicated that chemotherapy was associated with a decreased risk of hemorrhage (P=0.006), but there was no reduction in the risk of hemorrhage associated with perforation and obstruction (P>0.05). The median overall survival time of GMLC patients was 2.8 months (range, 0–108 months). The survival analyses revealed that perforation and extra-GI metastasis were negative prognostic factors but abdominal surgery was identified a positive prognostic factor. In conclusion, the histological distribution of GMLC differed from that of primary lung cancer. Sufficient and careful patient evaluation, targeted surgeries and systemic therapies for specific patients are able to increase patient survival rate and improve the quality of life.
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Affiliation(s)
- Yue Hu
- Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Noah Feit
- The Johns Hopkins University, Baltimore, MD 21231, USA
| | - Yanqin Huang
- Cancer Institute, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Wenhong Xu
- Department of Radiation Oncology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Shu Zheng
- Department of Surgical Oncology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, P.R. China.,Cancer Institute, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Xiuzhen Li
- Department of Pathology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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Gastric Metastases from Lung Adenocarcinoma Causing Gastrointestinal Bleeding. ACG Case Rep J 2017; 4:e25. [PMID: 28286791 PMCID: PMC5340659 DOI: 10.14309/crj.2017.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 12/08/2016] [Indexed: 12/16/2022] Open
Abstract
Metastases to the stomach are rare. They are commonly asymptomatic, and the diagnosis is usually established during autopsy. We present a patient known to have stage IV lung adenocarcinoma who presented with melena and shock. Endoscopy revealed multiple gastric nodules, which were proved to be metastatic deposits from her lung cancer. The possibility of gastric metastases should be kept in mind in patients presenting with gastrointestinal bleeding. Endoscopy and biopsy remain the gold standard for diagnostic testing in such patients.
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Huang Q, Su X, Bella AE, Luo K, Jin J, Zhang S, Luo G, Rong T, Fu J. Clinicopathological features and outcome of gastric metastases from primary lung cancer: A case report and systematic review. Oncol Lett 2014; 9:1373-1379. [PMID: 25663915 PMCID: PMC4315035 DOI: 10.3892/ol.2014.2830] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 08/29/2014] [Indexed: 12/25/2022] Open
Abstract
Primary lung cancer is the fourth most frequently diagnosed cancer, but gastric metastasis from lung cancer is extremely rare. Little is known about its clinicopathological features, prognosis and optimal treatment strategy. The present study reports a case of primary lung cancer that metastasized to the stomach and to the best of our knowledge, is the first to identify discordance in epidermal growth factor receptor (EGFR) mutation status between the primary tumor and gastric metastasis. The study also systematically searched the Medline database for similar cases to provide a literature review. Data concerning the clinicopathological features, treatment strategies and outcomes were extracted and analyzed. In total, 22 eligible cases were identified from 16 studies. The average age at presentation was 67.3 years and there was a male predominance of 90.9%. Epigastric pain (45.5%) was the most common chief complaint, followed by melena (22.7%), nausea/vomiting (13.6%) and hematemesis (9.1%). Three patients were asymptomatic. Five patients sought the initial consultation for gastrointestinal symptoms. The median time between the primary lung cancer diagnosis and the confirmation of gastric metastasis was five months. Endoscopically, gastric lesions were described as polypoid masses or volcano-like ulcers, mostly involving the gastric corpus, which were identified in 62.5% of the 16 cases in which information regarding the site of metastasis was available. Gastric metastases were reported from adenocarcinoma, squamous cell carcinoma, small cell lung cancer and pleomorphic carcinoma of the lung. The median survival following comprehensive treatment strategies was four months, and the one-year post-metastasis survival rate was 35.3%. In conclusion, although primary lung cancer metastasis to the stomach is rare, clinicians should be aware of the possibility of its occurrence. Comprehensive and personalized treatment may be beneficial to patients. EGFR tyrosine-kinase inhibitor therapy may be the treatment of choice for non-small cell lung carcinoma patients harboring an activating EGFR mutation in the metastatic lesion.
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Affiliation(s)
- Qingyuan Huang
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Guangdong Esophageal Cancer Research Institute, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Xiaodong Su
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Amos Ela Bella
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Guangdong Esophageal Cancer Research Institute, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Kongjia Luo
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Guangdong Esophageal Cancer Research Institute, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Jietian Jin
- Department of Pathology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Shuishen Zhang
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Guangdong Esophageal Cancer Research Institute, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Guangyu Luo
- Department of Endoscopy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Tiehua Rong
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Guangdong Esophageal Cancer Research Institute, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
| | - Jianhua Fu
- Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China ; Guangdong Esophageal Cancer Research Institute, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China
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Katsenos S, Archondakis S. Solitary gastric metastasis from primary lung adenocarcinoma: a rare site of extra-thoracic metastatic disease. J Gastrointest Oncol 2013; 4:E11-5. [PMID: 23730522 DOI: 10.3978/j.issn.2078-6891.2012.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 10/24/2012] [Indexed: 12/12/2022] Open
Abstract
Lung cancer metastasizing to gastrointestinal (GI)-tract is a rare event. Gastric metastasis is usually asymptomatic but when mucosal in location it may cause symptoms as demonstrated in the current case. This report describes a 60-year old male who was admitted for evaluation of a left upper lobe lung mass with associated bilateral nodular opacities and mediastinal lymphadenopathy. After thorough work-up the diagnosis of advanced lung adenocarcinoma was made. During hospitalization period and prior to starting chemotherapy, he exhibited upper gastrointentinal bleeding. Esophagogastroduodenoscopy revealed an ulcerative lesion in the gastric corpus representing metastasis of the primary lung carcinoma that ensued from immunohistochemical analysis. Clinical, pathological and therapeutic aspects of this uncommon site of extrathoracic metastatic disease are discussed, emphasizing the importance of the immunohistochemistry in the differential diagnosis of lung carcinomas whether primary or secondary to the lung.
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Affiliation(s)
- Stamatis Katsenos
- Department of Pneumonology, General Army Hospital of Athens, Athens, Greece
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Nishizawa Y, Kobayashi A, Saito N, Nagai K, Sugito M, Ito M, Nishizawa Y. Surgical management of small bowel metastases from primary carcinoma of the lung. Surg Today 2011; 42:233-7. [PMID: 22045233 DOI: 10.1007/s00595-011-0005-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 03/01/2011] [Indexed: 12/16/2022]
Abstract
PURPOSE To investigate the treatment and outcomes in a series of seven cases of small bowel metastases from lung cancer. METHODS A total of 4114 patients with lung cancer were referred to this institution from 1995 to 2005. Seven (0.17%) developed symptomatic small bowel metastasis and were treated surgically. The clinical, radiological, and pathological records were reviewed. RESULTS Small bowel metastases were diagnosed from 0 to 31 months (mean 11.5 months) after the diagnosis of lung cancer. The clinical symptoms at presentation were acute peritonitis in two patients and abdominal pain in five. Small bowel metastasis was suspected on abdominal X-ray in three cases, computed tomography in two, small bowel radiography in one, and endogastroduodenoscopy in one. All patients underwent surgery and there were no perioperative deaths. Intestinal resection was performed in five cases and a bypass in two. A small bowel metastasis was found in the ileum in four patients. The mean survival period was 7.7 months after surgery. One patient lived for 22 months after bowel resection. Oral intake was possible 1 month after surgery in six cases. CONCLUSION Surgical management should be considered as palliative treatment in patients with a bowel obstruction or peritonitis caused by primary lung cancer.
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Affiliation(s)
- Yuji Nishizawa
- Colorectal and Pelvic Surgery Division, Department of Surgical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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Kanthan R, Sharanowski K, Senger JL, Fesser J, Chibbar R, Kanthan SC. Uncommon mucosal metastases to the stomach. World J Surg Oncol 2009; 7:62. [PMID: 19650900 PMCID: PMC2734526 DOI: 10.1186/1477-7819-7-62] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Accepted: 08/03/2009] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Metastases to the stomach from an extra-gastric neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy. The stomach may be involved by hematogenous spread from a distant primary (most commonly breast, melanoma or lung), or by contiguous spread from an adjacent malignancy, such as the pancreas, esophagus and gallbladder. These latter sites may also involve the stomach via lymphatic or haematogenous spread. We present three cases of secondary gastric malignancy. METHODS/RESULTS The first is a 19-year-old male who received a diagnosis of testicular choriocarcinoma in September 2004. Metastatic malignancy was demonstrated in the stomach after partial gastrectomy was performed to control gastric hemorrhage. The second is a 75-year-old male, generally well, who was diagnosed with adenocarcinoma of the lung in September 2005. Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric polyps". The third is an 85-year-old man with no known history of malignancy who presented for evaluation of iron deficiency anemia by endoscopy in February 2006. Biopsies of the colonic and gastric mucosa demonstrated moderately differentiated invasive colonic adenocarcinoma with metastatic deposits in the stomach. CONCLUSION While the accurate recognition of these lesions at endoscopy is fraught with difficulty, pathological awareness of such uncommon metastases in the gastric mucosa is essential for accurate diagnosis and optimal patient management.
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Affiliation(s)
- R Kanthan
- Department of Pathology & Laboratory Medicine, College of Medicine, Saskatoon, Saskatchewan, Canada.
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Alpar S, Kurt OK, Ucar N, Orsel O, Aydog G, Kurt B. A case of squamous cell lung carcinoma with gastric metastasis. South Med J 2007; 99:1313-4. [PMID: 17195443 DOI: 10.1097/01.smj.0000240697.56774.45] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Yang CJ, Hwang JJ, Kang WY, Chong IW, Wang TH, Sheu CC, Tsai JR, Huang MS. Gastro-intestinal metastasis of primary lung carcinoma: clinical presentations and outcome. Lung Cancer 2006; 54:319-23. [PMID: 17010474 DOI: 10.1016/j.lungcan.2006.08.007] [Citation(s) in RCA: 136] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2006] [Revised: 08/17/2006] [Accepted: 08/22/2006] [Indexed: 02/08/2023]
Abstract
Symptomatic gastro-intestinal (GI) metastasis in lung carcinomas is extremely rare and only a few case reports have been published. Here we review all of the cases of lung cancer from January 2003 to April 2005 in a tertiary teaching hospital in Taiwan. A total of six patients (1.77%, 6/339) with primary lung cancer demonstrated symptomatic gastro-intestinal metastasis. Three patients had squamous cell carcinoma, one had adenocarcinoma, and two had small cell carcinoma. Three patients with gastric metastasis were diagnosed via gastro-endoscopy while one with cecal involvement was diagnosed via colon fiberscopy. Two patients with small bowel perforation and intussusception were diagnosed via laparotomy. We presented these rare cases and made a review of the literature.
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Affiliation(s)
- Chih-Jen Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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