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Lung cancer with metastases to the stomach and duodenum. report of three cases
Author(s) -
Nakamura Hiroshi,
Mizokami Yuji,
Iwaki Yoshiki,
Shiraishi Takahisa,
Ohtsubo Toshiya,
Miura Shuhei,
Narasaka Toshiaki,
Matsuoka Takeshi
Publication year - 2003
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1046/j.1443-1661.2003.00248.x
Subject(s) - medicine , duodenum , stomach , metastasis , esophagogastroduodenoscopy , duodenal cancer , cancer , gastroenterology , stage (stratigraphy) , lung cancer , jaundice , lung , endoscopy , surgery , paleontology , biology
Over a period of about 1.5 years between September 1999 and April 2000, three cases of lung cancer that metastasized to the stomach and duodenum were encountered. Case 1 was a 74‐year‐old man with lung cancer at stage IV. During chemotherapy, he passed tarry feces, which led to an endoscopic examination. Subsequently, submucosal tumorous nodules were recognized in the stomach and descending portion of the duodenum, which were diagnosed as metastases. Case 2, a 59‐year‐old man, underwent radiotherapy for treatment of lung cancer at stage IV. He developed obstructive jaundice 15 months later and, following percutaneous drainage to correct the icteric condition, endoscopic examination was conducted. A 5‐cm submucosal tumor was found at the descending portion of the duodenum and a diagnosis of obstructive jaundice caused by a duodenal metastasis was given. Case 3, an 81‐year‐old male with stage IIIb lung cancer had been receiving oral Tegafur uracil. Because of hypochondriac pain that had lasted for 2 weeks, an endoscopic examination was conducted. A tumorous lesion was discovered in the horizontal part of the duodenum, which proved to be a metastasis. Metastasis of a lung cancer to the digestive system is rare: gastric metastasis is only 4.5% and metastasis to the small intestine, 5.8%. However, our experience suggests that metastases to the digestive system occur more frequently than reports would indicate. Endoscopic screening should be aggressively used, not only for those cases that develop subjective symptoms, but also for the asymptomatic cases to assess accuracy in staging, which may contribute to choosing the most appropriate therapeutic plan.