Iron deficiency anemia as initial presentation of a non-small cell lung carcinoma: A case report

Abstract

Duodenal metastases secondary to lung cancer are very rare and most of the time asymptomatic. When symptomatic they usually present with bowel obstruction or perforation. We here describe the case of a 68 year-old man with a solitary metastasis in the duodenum from a non-small cell lung carcinoma (NSCLC). The patient presented with reduced exercise tolerance and iron deficiency anemia without clinical gastrointestinal blood loss. Further investigation showed a tumor in the left upper lung lobe and a duodenal metastasis for which he received chemotherapy. To the best of our knowledge this is the first case report of iron deficiency anemia as initial presentation of a duodenal metastasis from a NSCLC.

Keywords: Anemia; Duodenal metastasis; Non-small cell lung carcinoma.

Fig. 1

Blanco-CT and FDG-PET/CT of the thorax showing a circular mass at the dorsal side of the left upper lobe with a diameter of 7.4 cm.

Fig. 2

Blanco-CT and FGD-PET/CT of the abdomen showing a solitary mass in the duodenum.

Fig. 3

Microscopic images of the primary NSCLC (A) and the duodenal metastasis (B). H&E, 400X. A: solid fields of polymorfic epithelial cells with enlarged nucleoli and a large amount of eosinofilic cytoplasm consistent with NSCLC. B: solid fields of large polymorfic epithelial cells with enlarged eosinofilic nucleoli and a large amount of eosinofilic cytoplasm, consistent with primary NSCLC.