World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website https://www.wjon.org

Case Report

Volume 13, Number 6, December 2022, pages 409-416

Intraluminal Small Bowel Metastasis From Primary Lung Cancer

Figures

Figure 1.
Figure 1. Axial (left) and coronal (right) views of a PET scan showing a hypermetabolic mass in the left upper quadrant small bowel loop (depicted by the red arrows), demonstrating a maximum SUV of 16.5 and measuring 2.9 cm in width. PET: positron emission tomography; SUV: standardized uptake value.
Figure 2.
Figure 2. Images from CT enterography in coronal and axial views revealing an abnormally distended conglomerate of small bowel loops (indicated by the red arrows) within the left upper abdominal quadrant measuring 7.3 × 4.9 cm, suggestive of a proximal jejunal mass. CT: computed tomography.
Figure 3.
Figure 3. (a) A large fungating mass in the distal duodenum. (b) A large nonbleeding polypoidal mass in the proximal jejunum visualized via push enteroscopy.
Figure 4.
Figure 4. Timeline summarizing the patient’s pertinent disease history. NSCLC: non-small cell lung cancer; CT: computed tomography; PET: positron emission tomography; FDG: 2-[18F] fluoro-2-deoxy-D-glucose; pRBCs: packed red blood cells; EGDS: esophagogastroduodenoscopy.

Table

Table 1. Reported Cases of Small Bowel Metastasis From Primary Non-Small Cell Lung Cancer Within the Past 5 Years
 
StudyPatient age and genderType of lung cancerSigns and symptomsLocation of small bowel metastasisMethod of concluding origin of metastasis
M: male; cm: centimeter; mm: millimeter; CT: computed tomography; PET: positron emission tomography; SBO: small bowel obstruction; CEA: carcinoembryonic antigen; EGDS: esophagogastroduodenoscopy.
Ogasawara et al (2022) [24]62 MAdenocarcinomaAbdominal pain, anemia, about 7 cm tumor in left abdomen on CTJejunumBiopsy from enteroscopy
Suzuki et al (2022) [25]70 MPleomorphic carcinomaGeneralized fatigue, abdominal pain, anemia, CT showed large mass in left abdominal cavity, endoscopy showed tumor in jejunumJejunumBiopsy from endoscopy and surgical resection
Kang et al (2021) [15]66 MAdenocarcinomaMelena, dizziness, anemia, 2 cm polypoidal lesion in second portion of duodenumTotal of 22 lesions in stomach, duodenum, jejunum, and ileum - ranging from 0.8 to 4.0 cmBiopsy from EGDS and surgical resections
O’Neill et al (2020) [26]56 MAdenocarcinomaHeadache and dysarthria from lung mass, small bowel mass noted on PET with no attributable symptomsSecond portion of duodenumBiopsy from gastroscopy
Xie et al (2020) [27]55 MPulmonary sarcomatoid carcinomaEpigastric pain, melena, anemia, PET showed wall thickening of small bowelDuodenum and jejunumSurgical resection
Xie et al (2020) [27]61 MPulmonary sarcomatoid carcinomaMelena, intermittent fevers, anemia, PET showed circumferential thickening of small intestinesSmall bowel - not fully describedBiopsy from gastroscopy
Plestina et al (2019) [28]57 MUndifferentiated pleomorphic sarcomaAcute abdomen secondary to bowel perforation, CT scan 3 months after lung surgery showed a 60 mm obstructive metastatic small bowel lesionIleumSurgical resection
Chen et al (2018) [29]69 MAdenocarcinomaBloating, decreased flatus, intestinal effusion and obstruction on CTSmall bowel - not fully describedSurgical resection
Ohira et al (2018) [30]75 MAdenocarcinomaMelena, anemia, capsule endoscopy showed polyp in small bowelJejunal massBiopsy from enteroscopy and autopsy
Janez et al (2017) [31]53 MAdenocarcinomaUpper abdominal pain, vomiting, constipation, SBO on CT, CEA elevatedMultiple metastatic lesions along small bowel and small bowel mesenterySurgical resection
Ying et al (2017) [32]59 MAdenocarcinomaMelena, anemia, fecal occult blood, CT and PET demonstrated small bowel massJejunumSurgical resection