A case of intestinal hemorrhage due to small intestinal metastases from primary lung cancer

Abstract

Although intestinal metastases from lung cancer are not rare at postmortem studies, the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. We report a case of small intestinal hemorrhage leading to intestinal perforation secondary to metastases from a large cell carcinoma of the lung in a 31-year-old man along with a review of the literature.

Fig. 1

Posteroanterior chest X-ray shows ill defined dense infiltrates with air bronchogram in the right lower lobe.

Fig. 2

Gross finding of mucosal surface. Thity-six dark brown polypoid masses are scattered along the full length of the small intestine. The largest one is 8.0×5.0×4.0 cm in size.

Fig. 3

The polypoid tumor of the intestine is composed of large round cells without pigment. The cells are relatively uniform in size.(H&E, ×100)

Fig. 4

Definitive desmosome (arrow) (uranyl acetate and lead citrate × 25,000)

Fig. 5

Bronchoscopy shows an obstructing mass at the entrance of the right main bronchus.

Fig. 6

Bronchoscopic biopsy specimen. The tumor cells are large round cells with cellular pleomorphism.(H&E, ×200)