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Vol.48 No.7 contents | Japanese/English |
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- Case Report -
A Case of Duodenal Metastasis from Lung Cancer with Axillary Leiomyosarcoma
Yojiro Yutaka1, Mitsugu Omasa1, Kei Shikuma1, Masato Okuda1, Toshihiko Taki11Respiratory Disease Center, Division of Thoracic Surgery, The Tazuke Kofukai Medical Research Institute Kitano Hospital, Japan
Background. Intestinal metastases, particularly to the duodenum, of lung cancer are rare. Though recently double-balloon enteroscopy and capsule enteroscopy allow observations in all segments of the alimentary tract, they are not widespread and are not available in most cases. On detecting duodenal metastases, most cases are too late to be treated because of their aggressive invasion. Furthermore, axillary leiomyosarcoma is very rare. Case. A subcutaneous tumor in the right axilla was detected before operation for left upper lobe lung cancer. Because the right axilla is an atypical site of metastasis, left upper lobectomy ND2a and axillary tumor resection was performed under a diagnosis of double cancer. Pathological examination revealed adenocarcinoma of the left lung with subcutaneous leiomyosarcoma of the right axilla. Though local recurrence of the right axillary leiomyosarcoma was completely resected, suddenly melena occurred. Upper gastro-intestinal fiberscopy revealed easily bleeding duodenal tumors which were difficult to treat because aggressive invasion to the peritoneum pancreas. Conclusion. A case of lung cancer with subcutaneous leiomyosarcoma is reported. The mass size and resected margin are important prognostic factors of subcutaneous leiomyosarcoma. Though no recurrence was detected after the additional resection of the margin in this case, there was no treatment option for the rapidly growing duodenal metastases. In general, cases of intestinal metastases from lung cancer have poor prognosis. Abdominal examinations should be performed carefully, because the detection of duodenal metastasis at an early stage of the disease could lead to a better outcome.
key words: Lung cancer, Duodenal metastasis, Leiomyosarcoma
Received: May 27, 2008
Accepted: October 1, 2008
JJLC 48 (7): 846-849, 2008
