J Korean Surg Soc.  2013 Jan;84(1):57-60.

Generalized peritonitis arising from small bowel metastasis in a lung cancer patient

• Park YJ
• Kim KY
• Park JY
• Cho JS
• Kim Y
• Shin SH

Abstract

Symptomatic gastrointestinal metastasis from lung malignancy is rarely reported. In this report, we present a case of lung adenocarcinoma with acute abdominal pain from small bowel perforation. The patient underwent small bowel resection and the final diagnosis was metastatic adenocarcinoma originating from lung. Immunohistochemistry was positive for thyroid transcription factor-1 and cytokeratin 7 (CK7), and negative for CK20. We present this rare case and briefly review the literature.

Keyword

Lung cancer; Gastrointestinal tract; Metastasis; Immunohistochemistry

MeSH Terms

Abdominal Pain
Adenocarcinoma
Gastrointestinal Tract
Humans
Immunohistochemistry
Keratin-7
Lung
Lung Neoplasms
Neoplasm Metastasis
Peritonitis
Thyroid Gland
Adenocarcinoma
Keratin-7
Lung Neoplasms

Figure

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  Fig. 1 (A) Chest computed tomography scan shows high density mass in right upper lobe. (B) Liver magnetic resonance imaging scan shows 1 cm sized nodule in segment 2.

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  Fig. 2 Abdomen computed tomography scans show liver metastasis with pneumoperitoneum (A) and small bowel edematous change with fluid collection in distal ileum (B).

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  Fig. 3 Microscopic findings of small bowel. (A) The small bowel mucosa shows infiltration of tumor cells (H&E, ×100). (B) The malignant cells show positive stain for cytokeratin 7 (CK7), suggesting not primary colon origin (immunohistochemical [IHC] stain, ×100). (C) Negative satin for thyroid transcription factor-1, suggesting lung cancer origin (IHC stain, ×100). (D) Negative stain for CK20 (IHC stain, ×100).

Reference

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