A patient with four-year survival after nonsmall cell lung carcinoma with a solitary metachronous small bowel metastasis

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.

Figure 1

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.

Figure 2

CT of the abdomen showing a solitary circular mass in the small bowel with surrounding fat infiltration.

Figure 3

CT of the abdomen 2 months after palliative radiotherapy showing absence of residual tumor in the jejunum.