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Microscopic images of the primary lung cancer and jejunal metastasis. H&E, 250X. (a), lung: a nest of large, polymorphous epithelial cells with strong mitotic activity and central necrosis is observed, consistent with large cell carcinoma (NSCLC). (b), jejunum: groups of large anaplastic cells invading the lamina propria.
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fig1: Microscopic images of the primary lung cancer and jejunal metastasis. H&E, 250X. (a), lung: a nest of large, polymorphous epithelial cells with strong mitotic activity and central necrosis is observed, consistent with large cell carcinoma (NSCLC). (b), jejunum: groups of large anaplastic cells invading the lamina propria.

Mentions: A 60-year-old woman, with a history of a superficially invasive urothelial cell carcinoma of the bladder, had undergone a lung bilobectomy in January 2004 for a carcinoma in the right upper lobe. At the time of diagnosis CT of the thorax and F-18-fluoro-positron emission tomography (FDG-PET) showed no evidence of lymph node involvement or distant metastases. Mediastinal lymph nodes were not sampled during surgery. Histopathological evaluation of the resected lung tissue revealed an undifferentiated large cell carcinoma of 3,3 cm in the lung parenchyma without pleural invasion or regional lymph node metastasis, T2N0M0 (Figure 1(a)). No postoperative adjuvant treatment was recommended.

A Patient with Four-Year Survival after Nonsmall Cell Lung Carcinoma with a Solitary Metachronous Small Bowel Metastasis

Kant KM, Noordhoek Hegt V, Aerts JG - J Oncol (2010)

Bottom Line: Solitary small bowel metastasis secondary to lung cancer is very uncommon.In this report, we present a patient with NSCLC and a metachronous solitary metastasis of the jejunum.To the best of our knowledge, this is the first case report describing a prolonged survival in a patient with a symptomatic solitary small bowel metastasis treated with palliative surgery, chemo- and radiotherapy instead of complete surgical resection.

Affiliation: Department of Pulmonology, Amphia Hospital, Molengracht 21, 4300 RK Breda, The Netherlands.

ABSTRACT
Solitary small bowel metastasis secondary to lung cancer is very uncommon. In this report, we present a patient with NSCLC and a metachronous solitary metastasis of the jejunum. She is alive without evidence of disease and doing well four years after palliative surgery, radiotherapy, and chemotherapy. To the best of our knowledge, this is the first case report describing a prolonged survival in a patient with a symptomatic solitary small bowel metastasis treated with palliative surgery, chemo- and radiotherapy instead of complete surgical resection.

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