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Multiple cutaneous and intestinal metastases in lung cancer: A case report.

Lu S, Yang J, Sun Y, Xu Z - Oncol Lett (2015)

Bottom Line: The patient subsequently experienced symptoms of rectal irritation.A digital rectal examination and colonoscopy were performed, and the consequent pathological biopsy identified moderately-differentiated adenocarcinoma.This case highlights the fact that a comprehensive analysis and examination should be performed for suspected cutaneous and intestinal lesions, during which, a pathological biopsy is of great importance in order to form the correct diagnosis for timely treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong 250031, P.R. China.

ABSTRACT

Lung cancer is a common malignant neoplasm that is prone to distant metastasis. However, the incidence of multiple cutaneous and intestinal metastases is rare. The present study describes the case of a 62-year-old female who was admitted to The Affiliated Hospital of Shandong Academy of Medical Sciences in August 2013 with multiple cutaneous lumps. Contrast-enhanced computed tomography showed nodules and masses in the right lung, and multiple enlarged lymph nodes in the mediastinum and right hilum. Biopsies of the lumps in the right lung and skin revealed moderately-differentiated adenocarcinoma, which were considered to be cutaneous metastases of lung cancer. The patient subsequently experienced symptoms of rectal irritation. A digital rectal examination and colonoscopy were performed, and the consequent pathological biopsy identified moderately-differentiated adenocarcinoma. After analyzing the results of previous pathological examinations and immunohistochemistry, it may be suggested that intestinal metastasis had developed. This case highlights the fact that a comprehensive analysis and examination should be performed for suspected cutaneous and intestinal lesions, during which, a pathological biopsy is of great importance in order to form the correct diagnosis for timely treatment.

No MeSH data available.


Related in: MedlinePlus

Clinical photograph showing (A) a lump on the top of the head and (B) a purple, protruding lump in the right armpit.
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f1-ol-09-04-1541: Clinical photograph showing (A) a lump on the top of the head and (B) a purple, protruding lump in the right armpit.

Mentions: A 62-year-old female was admitted to The Affiliated Hospital of Shandong Academy of Medical Sciences in August 2013 with multiple lumps in the right thigh, armpit and scalp that had been present for one month. A number of these lumps had ulcerated two weeks prior to the visit. Three lumps were observed on the scalp, among which the top lump was the largest. This lump was a hard, 3×2 cm protrusion, which was recessed and ulcerated at the center, with a clear embankment-like boundary. The other two bulges looked like craters, with clear boundaries and no ulceration or exudation. No tenderness was reported. In addition, a furuncle-like lump was found on the right thigh, which was swollen and ulcerated, with mild tenderness. A purple, protruding 2×2-cm lump could also be observed in the right armpit, with furuncle-like embossing of the top and clear boundaries. The lump was of moderate texture, with a certain degree of tenderness (Fig. 1). Upon physical examination, chest auscultation revealed clear breathing sounds for the left lung, while those of the right lung were comparatively lower. There was no rhonchus or moist rale and other parameters were normal. Chest computed tomography (CT) showed nodules and masses in the right lung, with multiple enlarged lymph nodes in the mediastinum and right hilum (Fig. 2). This suggested a diagnosis of primary right lung cancer with intrapulmonary and lymphatic metastases in the mediastinum and right hilum. Resection of the tumors on the scalp, right thigh and armpit was performed due to the ulcerated cutaneous nature of the tumors. Pathological examination showed moderately-differentiated adenocarcinoma, which was considered to be metastatic cancer. A percutaneous biopsy of the right lung tumor showed moderately-differentiated adenocarcinoma. During the hospitalization period, the patient experienced increased stool frequency without obvious cause, which included tenesmus with blood and pus, but no abdominal pain, nausea or vomiting. A digital rectal examination revealed blood and a 4×3-cm lump at the rear of the perineal area, which was compressing the rectum. Colonoscopy showed a 0.3×0.3-cm lump on the inside of the transverse colon, which exhibited a rough mucosal membrane on the top, with clear boundaries. An ulcer with a diameter of ~1 cm, a recessed center, a peripheral bulge and a hard texture was observed on the rectum (Fig. 3). Biopsies were taken from the two sites, which were both subsequently diagnosed as moderately-differentiated adenocarcinoma. A similar pathology as that shown on light microscopy (Fig. 4) and similar immunohistochemistry results (Table I) indicated that the tumors in the intestines, scalp and thigh were all metastases of the primary lung cancer. The patient is currently undergoing systemic chemotherapy with intravenous gemcitabine (1.4 g, days 1 and 8) and cisplatin (40 mg, days 1–3) every two weeks. At the time of writing, the patient had undergone eight weeks of a six month treatment. However, as the patient exhibits multiple cutaneous metastases and intestinal metastasis, the expected surival time is poor.


Multiple cutaneous and intestinal metastases in lung cancer: A case report.

Lu S, Yang J, Sun Y, Xu Z - Oncol Lett (2015)

Clinical photograph showing (A) a lump on the top of the head and (B) a purple, protruding lump in the right armpit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356377&req=5

f1-ol-09-04-1541: Clinical photograph showing (A) a lump on the top of the head and (B) a purple, protruding lump in the right armpit.
Mentions: A 62-year-old female was admitted to The Affiliated Hospital of Shandong Academy of Medical Sciences in August 2013 with multiple lumps in the right thigh, armpit and scalp that had been present for one month. A number of these lumps had ulcerated two weeks prior to the visit. Three lumps were observed on the scalp, among which the top lump was the largest. This lump was a hard, 3×2 cm protrusion, which was recessed and ulcerated at the center, with a clear embankment-like boundary. The other two bulges looked like craters, with clear boundaries and no ulceration or exudation. No tenderness was reported. In addition, a furuncle-like lump was found on the right thigh, which was swollen and ulcerated, with mild tenderness. A purple, protruding 2×2-cm lump could also be observed in the right armpit, with furuncle-like embossing of the top and clear boundaries. The lump was of moderate texture, with a certain degree of tenderness (Fig. 1). Upon physical examination, chest auscultation revealed clear breathing sounds for the left lung, while those of the right lung were comparatively lower. There was no rhonchus or moist rale and other parameters were normal. Chest computed tomography (CT) showed nodules and masses in the right lung, with multiple enlarged lymph nodes in the mediastinum and right hilum (Fig. 2). This suggested a diagnosis of primary right lung cancer with intrapulmonary and lymphatic metastases in the mediastinum and right hilum. Resection of the tumors on the scalp, right thigh and armpit was performed due to the ulcerated cutaneous nature of the tumors. Pathological examination showed moderately-differentiated adenocarcinoma, which was considered to be metastatic cancer. A percutaneous biopsy of the right lung tumor showed moderately-differentiated adenocarcinoma. During the hospitalization period, the patient experienced increased stool frequency without obvious cause, which included tenesmus with blood and pus, but no abdominal pain, nausea or vomiting. A digital rectal examination revealed blood and a 4×3-cm lump at the rear of the perineal area, which was compressing the rectum. Colonoscopy showed a 0.3×0.3-cm lump on the inside of the transverse colon, which exhibited a rough mucosal membrane on the top, with clear boundaries. An ulcer with a diameter of ~1 cm, a recessed center, a peripheral bulge and a hard texture was observed on the rectum (Fig. 3). Biopsies were taken from the two sites, which were both subsequently diagnosed as moderately-differentiated adenocarcinoma. A similar pathology as that shown on light microscopy (Fig. 4) and similar immunohistochemistry results (Table I) indicated that the tumors in the intestines, scalp and thigh were all metastases of the primary lung cancer. The patient is currently undergoing systemic chemotherapy with intravenous gemcitabine (1.4 g, days 1 and 8) and cisplatin (40 mg, days 1–3) every two weeks. At the time of writing, the patient had undergone eight weeks of a six month treatment. However, as the patient exhibits multiple cutaneous metastases and intestinal metastasis, the expected surival time is poor.

Bottom Line: The patient subsequently experienced symptoms of rectal irritation.A digital rectal examination and colonoscopy were performed, and the consequent pathological biopsy identified moderately-differentiated adenocarcinoma.This case highlights the fact that a comprehensive analysis and examination should be performed for suspected cutaneous and intestinal lesions, during which, a pathological biopsy is of great importance in order to form the correct diagnosis for timely treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, Shandong 250031, P.R. China.

ABSTRACT

Lung cancer is a common malignant neoplasm that is prone to distant metastasis. However, the incidence of multiple cutaneous and intestinal metastases is rare. The present study describes the case of a 62-year-old female who was admitted to The Affiliated Hospital of Shandong Academy of Medical Sciences in August 2013 with multiple cutaneous lumps. Contrast-enhanced computed tomography showed nodules and masses in the right lung, and multiple enlarged lymph nodes in the mediastinum and right hilum. Biopsies of the lumps in the right lung and skin revealed moderately-differentiated adenocarcinoma, which were considered to be cutaneous metastases of lung cancer. The patient subsequently experienced symptoms of rectal irritation. A digital rectal examination and colonoscopy were performed, and the consequent pathological biopsy identified moderately-differentiated adenocarcinoma. After analyzing the results of previous pathological examinations and immunohistochemistry, it may be suggested that intestinal metastasis had developed. This case highlights the fact that a comprehensive analysis and examination should be performed for suspected cutaneous and intestinal lesions, during which, a pathological biopsy is of great importance in order to form the correct diagnosis for timely treatment.

No MeSH data available.


Related in: MedlinePlus