A Case of Small Cell Carcinoma of the Lung with Sigmoid Colon Stenosis due to Lymph Node Metastasis

Takashi Tani, Masahiro Matsushita, Takayoshi Akiyama, Masato Kiriyama, Fujio Tomita, Hitoshi Saito, Ichiro Kita, Shigeki Takashima

Department of Surgery (II), Kanazawa Medical University

We report a case of small cell carcinoma of the lung with sigmoid colon stenosis due to lymph node metastasis. The patient was a 42-year-old male who had received radiochemotherapy for small cell carcinoma of the lung. Lower abdominal pain appeared and narrowing of the feces was noted, and then he was referred to our department. An elastic hard, immovable mass was palpated in the left lower abdomen. Blood chemistry findings showed abnormally high values for CEA and CA19-9, and the occult blood reaction for the feces was positive. A barium enema showed a filling defect in the sigmoid colon, and colonoscopy revealed an elevated lesion associated with a central depression and extramural compression. Sigmoidectomy was performed. Intraoperative findings showed swellings from the periaortic lymph nodes to the sigmoid mesocolonic lymph nodes and stenosis of the sigmoid colon caused by invasion of the wall of the enlarged parietal lymph node. The histopathological findings revealed lymph node metastasis of small cell carcinoma of the lung. He died of sepsis during chemotherapy 16 weeks after the operation. Small cell carcinoma of the lung seems to have a high potential for malignancy and shows distal organ metastasis frequently, but cases with metastasis to the large bowel are extremely rare.

Key words
small cell carcinoma of the lung, epicolic lymph node metastasis of sigmoid colon

Reprint requests
Takashi Tani Department of Surgery (II), Kanazawa Medical University
1-1 Daigaku, Uchinada-Machi, Kahoku-Gun, Ishikawa, 920-02 JAPAN

Accepted
January 11, 1995

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