A Case of Small Intussusception to be Caused by Small Intestinal Metastases from Lung Carcinoma Compatible to Pleomorphic Carcinoma

Yoshifumi Fujita, Michitoshi Ito, Norio Kageyama and Hisakazu Yamagishi*

Department of Surgery, Uji Hospital
Department of Surgery and Oncology of Digestive System, Kyoto Prefectural University of Medicine, Graduate School Medical Science*

We report the case of a 75-year-old man who had undergone left upper lobectomy by video-assisted thoracoscopic surgery for primary lung cancer. The pathological diagnosis according to the recently revised WHO classification was a pleomorphic carcinoma. The postoperative course was uneventful, but anemia developed three months after the lobectomy. An abdominal x-ray film revealed an air-fluid level, and intestinal obstruction was diagnosed. Fluoroscopy of the small intestine through an ileus tube revealed stenosis 50 cm distal to the ligament of Treitz. A CT scan showed layered intraperitoneal structure. Intussusception due to small bowel metastasis of the lung cancer was suspected on the basis of these findings and laparotomy was performed. At surgery, the jejunum that was involved in the intussusception was 50 cm distal to the ligament of Treitz and had formed mass the size of an infant's fist. Partial resection of the small intestine was performed, and histological examination revealed a small intestinal metastasis of the lung cancer. The patient remains recurrence-free 16 months after surgery.

Key words
pleomorphic carcinoma, lung cancer, small intestinal intussusception

Reprint requests
Yoshifumi Fujita Department of Surgery, Uji Hospital
54-2 Shibanohigashi, Gokasyo, Uji, 611-0011 JAPAN

Accepted
March 30, 2005

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