Capsule Endoscopy-Based Diagnosis of Lung Squamous Cell Carcinoma Associated with Abdominal Pain and Metastasis to Small Intestine: A Case Report

Abstract

Gastrointestinal metastases of lung cancer are relatively uncommon, yet occur at a higher frequency than would be expected among patients that exhibit a longer survival interval. Metastases that arise in the small intestines are often associated with no or few symptoms such that their early diagnosis can be challenging. In this report, we describe an extremely rare case of a lung squamous cell carcinoma that had metastasized to the small intestine and was associated with symptoms of abdominal pain. The patient underwent capsule endoscopy which detected an irregular mass in the distal ileum that was hemorrhagic, after which laparoscopic ileal resection and anastomosis in parallel with partial bladder resection were performed. Subsequent pathological biopsy confirmed that the intestinal mass was consistent with metastatic squamous cell carcinoma. With surgery and subsequent maintenance therapy with targeted drugs, the survival of the patient was more than 6 months. As a noninvasive testing strategy, capsule endoscopy can be easily performed to support etiological diagnostic efforts in cases where other diagnostic options are lacking. Early diagnosis and therapeutic intervention can contribute to better prognostic outcomes for GMLC patients.

© 2023 The Author(s). Published by S. Karger AG, Basel

References Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394–424. Zhou B, Zang R, Zhang M, Song P, Liu L, Bie F, et al. Worldwide burden and epidemiological trends of tracheal, bronchus, and lung cancer: a population-based study. EBioMedicine. 2022 Mar 18;78:103951. Arnold M, Rutherford MJ, Bardot A, Ferlay J, Andersson TM, Myklebust TÅ, et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995-2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 2019;20(11):1493–505. Misiakos EP, Gouloumi AR, Schizas D, Damaskou V, Tsapralis D, Farrugia FA, et al. Small bowel perforation with multiple intestinal metastases from lung carcinoma: a case report. Oncol Lett. 2019 Apr;17(4):3862–6. Hu Y, Feit N, Huang Y, Xu W, Zheng S, Li X. Gastrointestinal metastasis of primary lung cancer: an analysis of 366 cases. Oncol Lett. 2018 Jun;15(6):9766–76. Song Y, Li M, Shan J, Ye X, Tang S, Fang X, et al. Acute small bowel obstruction: a rare initial presentation for the metastasis of the large-cell carcinoma of the lung. World J Surg Oncol. 2012;10:26. Leduc C, Prim N, Mennecier B, Delvaux M, Gangi A, Quoix E. Diagnosis of jejunal metastases from lung cancer using capsule endoscopy. Case Rep Oncol. 2016 Sep 13;9(3):526–9. Yoshimoto A, Kasahara K, Kawashima A. Gastrointestinal metastases from primary lung cancer. Eur J Cancer. 2006 Dec;42(18):3157–60. Salemis NS, Nikou E, Liatsos C, Gakis C, Karagkiouzis G, Gourgiotis S. Small bowel perforation secondary to metastatic non-small cell lung cancer. A rare entity with a dismal prognosis. J Gastrointest Cancer. 2012 Sep;43(3):391–5. Garavello A, Fransvea P, Rossi S, Giacovazzo F, Marino V. Bowel perforation secondary to metastatic lung cancer: report of two cases with literature review. Int J Surg Case Rep. 2018;51:331–4. Liu W, Zhou W, Qi WL, Ma YD, Xu YY. Gastrointestinal hemorrhage due to ileal metastasis from primary lung cancer. World J Gastroenterol. 2015;21(11):3435–40. Fukumoto A, Tanaka S, Shishido T, Takemura Y, Oka S, Chayama K. Comparison of detectability of small-bowel lesions between capsule endoscopy and double-balloon endoscopy for patients with suspected small-bowel disease. Gastrointest Endosc. 2009;69(4):857–65. Pennazio M, Spada C, Eliakim R, Keuchel M, May A, Mulder CJ, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of smallbowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2015;47(4):352–76. Gerson LB, Fidler JL, Cave DR, Leighton JA. ACG clinical guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015;110(9):1265–87; quiz 1288. Lin HC, Yu CP, Lin HA, Lee HS. A case of lung cancer metastasized to the gastrointestinal anastomosis site where the primary gastric cancer was resected 17 years ago. Lung Cancer. 2011;72(2):255–7. Kim MC, Jang MH, Ahn JH. Metastatic large cell carcinoma of the lung: a rare cause of acute small bowel obstruction. Thorac Cancer. 2020 Nov;11(11):3379–82. Rossi G, Marchioni A, Romagnani E, Bertolini F, Longo L, Cavazza A, et al. Primary lung cancer presenting with gastrointestinal tract involvement: clinicopathologic and immunohistochemical features in a series of 18 consecutive cases. J Thorac Oncol. 2007 Feb;2(2):115–20. Gonzalez-Tallon AI, Vasquez-Guerrero J, Garcia-Mayor MA. Colonic metastases from lung carcinoma: a case report and review of the literature. Gastroenterol Res. 2013 Feb;6(1):29–33. Yuen JSP, Chow PKH, Ahmed Q. Metastatic lung cancer causing bowel perforations: spontaneous or chemotherapy-related?ANZ J Surg. 2002 Mar;72(3):245–6. Jeba J, Backianathan S, Ishitha G, Singh A. Oral and gastrointestinal symptomatic metastases as initial presentation of lung cancer. BMJ Case Rep. 2016 Nov 18;2016:bcr2016217539. Goh BK, Yeo AW, Koong HN, Ooi LL, Wong WK. Laparotomy for acute complications of gastrointestinal metastases from lung cancer: is it a worthwhile or futile effort?Surg Today. 2007;37(5):370–4. Lamberti G, Andrini E, Sisi M, Rizzo A, Parisi C, Di Federico A, et al. Beyond EGFR, ALK and ROS1: current evidence and future perspectives on newly targetable oncogenic drivers in lung adenocarcinoma. Crit Rev Oncol Hematol. 2020 Dec;156:103119. Rizzo A, Cusmai A, Giovannelli F, Acquafredda S, Rinaldi L, Misino A, et al. Impact of proton pump inhibitors and histamine-2-receptor antagonists on non-small cell lung cancer immunotherapy: a systematic review and meta-analysis. Cancers. 2022 Mar 9;14(6):1404. Viscardi G, Tralongo AC, Massari F, Lambertini M, Mollica V, Rizzo A, et al. Comparative assessment of early mortality risk upon immune checkpoint inhibitors alone or in combination with other agents across solid malignancies: a systematic review and meta-analysis. Eur J Cancer. 2022 Dec;177:175–85. Di JZ, Peng JY, Wang ZG. Prevalence, clinicopathological characteristics, treatment, and prognosis of intestinal metastasis of primary lung cancer: a comprehensive review. Surg Oncol. 2014 Jun;23(2):72–80. Ying X, Wang M, Verma V, Wang M, Ye S, Bi J, et al. Metastatic spread of solid subtype lung adenocarcinoma to the small intestine with anemia and melena: a case report. Medicine. 2017 Aug;96(34):e7768. Author Contacts

Xianjun Tang, iraqvictor@163.com

Article / Publication Details

Received: September 28, 2022
Accepted: January 02, 2023
Published online: February 20, 2023
Issue release date: January – December

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0


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