A Case of Small Bowel Metastasis in Squamous Cell Lung Cancer as Acute Abdomen

Kenji Nakamura, Takuya Egami, Shinji Momii and Masahisa Tabata

Department of Surgery, Higashikunisaki Municipal General Hospital

A 78-year-old man with a history of lung cancer surgery, reporting abdominal pain was found in physical examination, abdominal X-ray, abdominal ultrasound examination, and abdominal CT to have an abscess-like lesion in the mid lower abdomen but no evidence of recurrence in the liver, lung, or brain. Exploratory laparotomy showed a tumor in the ileum 60 cm proximal to Bauhin's valve, necessitating partial resection of the ileum. Histological studies showed specimens of the small bowel lesion to be squamous cell carcinoma, similar to those of the resected lung specimen. One month later, abdominal CT showed multiple liver metastases and he died 3 months after the operation because of liver failure. Surgeons should thus note whether patients with lung cancer have abdominal symptoms due to the presence of intestinal metastasis. Metastasis from primary carcinoma of the lung to the small bowel is associated with a poor prognosis, but aggressive surgery is associated with successful palliation and improved short-term survival.

Key words
acute abdomen, lung cancer, small bowel metastasis

Reprint requests
Kenji Nakamura Department of Surgery, Fukuoka Prefectual Kaho Hospital
265 Taromaru, Honami-cho, Kaho-gun Fukuoka-ken, 820-0076 JAPAN

Accepted
January 28, 2004

To read the PDF file you will need Abobe Reader installed on your computer.