Lung cancer metastases in jejunum: a case report

Aims Our aim is to present the morphology of metastases in small intestine

Methods We present the case of a 72-year-old male, obese, with only one kidney, smoker, who came to our center due to paresthesias and loss of strength in the right upper limb, and also partial loss of vision.A cranial CT scan was performed at the Emergency Service, showing hypodensity in the white substance of the right frontal lobe. He was admitted to the Neurology Department.During his stay in hospital, the patient had several episodes of melena, so a gastroscopy was requested. In this gastroscopy, a 1.5cm Forrest III ulcer was observed in duodenum, with hematic remains, which was treated with diluted adrenaline in its four quadrants.

To complete the study, a complete CT scan was requested, showing right pulmonary neoplasia with carcinomatous lymphangitis, bilateral hilar and mediastinal lymph node extension and metastatic pleural effusion. It was found a localized thickness at jejunum, associated with pathological mesenteric adenopathies; which could correspond to atypical metastases in the small intestine.Due to the persistence of anemia during his stay (hemoglobin 7 despite blood transfusion), it was decided to perform a push enteroscopy to study the lesion which had been found in the jejunum by CT scan.In this enteroscopy, several umbilicated lesions with central ulcerations were observed beyond the second part of duodenum, which became larger at jejunum; some of them with signs of recent bleeding, and adherent clots. Biopsies of these lesions were taken (with a hard consistency while biopsy taking).

Results They were diagnosed as metastases of the already known pulmonary carcinoma (TTF1+, CD45-).

Conclusions As a conclusion, we can affirm that lung cancer metastases can appear in small intestine, having form of umbilicated lesions which may have ulcers on its surface and may also be a cause of bleeding

Publication History

Article published online:
15 April 2024