J Korean Soc Radiol.  2016 Feb;74(2):91-95. 10.3348/jksr.2016.74.2.91.

Duodenal Metastasis of Pulmonary Pleomorphic Carcinoma: A Case Report

• Jeong SH
• Paik SH
• Lee NS
• Koh ES
• Shin HK
• Cha JG
• Park JS

• KMID: 2152600
• DOI: http://doi.org/10.3348/jksr.2016.74.2.91

Abstract

Pulmonary pleomorphic carcinoma is an uncommon malignant lesion of the lung. A chest radiograph of 53-year-old man who was suffering from a cough revealed a well-defined mass-like opacity with a broad base on the pleura at the apico-posterior segment of the right upper lobe of the lung. The subsequent chest computed tomography (CT) scan demonstrated an inhomogeneous enhancing mass with central low-attenuation in the right upper lobe. A lobectomy was performed and the mass was determined to be a pleomorphic carcinoma with visceral pleura invasion. Forty days after the operation, the patient complained of melena and an abdominal CT revealed an intraluminal and extraluminal protruding mass around the prepyloric antrum and duodenal bulb. The mass was removed by en-block surgery and diagnosed as metastatic pleomorphic carcinoma from the lung. Previous articles reported a median survival time of 3-10 months for pleomorphic carcinoma, but in this case, the patient has continued to survive, 11 years after surgery. Chest and abdominal CTs have revealed no evidence of tumor recurrence or metastasis.

MeSH Terms

Cough
Duodenal Neoplasms
Humans
Lung
Lung Neoplasms
Melena
Middle Aged
Neoplasm Metastasis*
Pleura
Radiography, Thoracic
Recurrence
Thorax
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Pleomorphic carcinoma of the lung in a 53-year-old man. A. A chest postero-anterior radiograph reveals a well-defined mass with a maximum diameter of 8.2 cm (arrows) in the right upper lobe. B. A transverse contrast-enhanced CT scan shows a 5.7 cm sized, inhomogeneously enhancing mass lesion with inner low attenuated area (star) in the peripheral lung area of the right upper lobe. The mass abutted the adjacent visceral pleura (arrow). C, D. Photomicrographs of histopathologic specimens (hematoxylin and eosin staining, × 200) show a mixed composition of spindle cell carcinoma (C) and giant cell carcinoma (D).

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  Fig. 2 Duodenal metastasis of pulmonary pleomorphic carcinoma. A. A transverse contrast-enhanced abdominal CT scan shows an intraluminal (arrow) and extraluminal (star) protruding mass around prepyloric antrum and duodenal bulb. B. A photograph of gross specimen of duodenum reveals well-defined serosal mass with extensive hemorrhagic necrosis and mucosal ulceration.

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