Korean J Gastrointest Endosc.  2010 Feb;40(2):102-106.

A Case of Gastric, Duodenal and Colonic Metastases from Adenocarcinoma of the Lung

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. jibjeong@snu.ac.kr
  • 2Department of Anatomic Pathology, Seoul National University College of Medicine, Seoul, Korea.

Abstract

Gastrointestinal metastasis of primary lung carcinoma is very rare, although this is found in about 4.7~14% of cases at autopsy. An 81-year-old man was admitted with masses in the lung, adrenal gland, bladder and colon on his CT scans. We suspected metastases of an unknown origin and we carried out EGD and colonoscopy to differentiate the primary origin of the metastases. The examination revealed a submucosal tumor-like mass with central erosion on the gastric antrum and colonic splenic flexure, and polypoid lesions with a central fissure on the second portion of the duodenum. All the endoscopic forcep biopsies showed poorly differentiated adenocarcinoma without evidence of foci of the preinvasive surface glandular lesions. Immunochemical analysis of the tumor cells showed positivity for thyroid transcription factor-1 and cytokeratin 7, and negativity for cytokeratin 20 and caudal-related homeobox 2. Therefore, we diagnosed this case as multiple gastrointestinal metastases of primary lung cancer. This is first case of gastric, duodenal and colonic metastases from adenocarcinoma of the lung in the medical literature.

Keyword

Gastrointestinal metastases; Primary lung cancer

MeSH Terms

Adenocarcinoma
Adrenal Glands
Aged, 80 and over
Autopsy
Biopsy
Colon
Colon, Transverse
Colonoscopy
Duodenum
Genes, Homeobox
Humans
Keratin-20
Keratin-7
Lung
Lung Neoplasms
Neoplasm Metastasis
Pyloric Antrum
Surgical Instruments
Thyroid Gland
Urinary Bladder
Keratin-20
Keratin-7
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