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Vol.52 No.3 contents | Japanese/English |
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- Case Report -
A Case of Small Bowel Metastasis of Lung Adenocarcinoma Initially Diagnosed and Observed During Chemotherapy with Double-balloon Enteroscopy
Kazunari Tateishi1, Tomonobu Koizumi2, Kazuhisa Urushihata1, Hiroshi Yamamoto1, Masayuki Hanaoka1, Keishi Kubo11First Department of Internal Medicine, Shinshu University School of Medicine, Japan, 2Comprehensive Cancer Center, Shinshu University Hospital, Japan
Background. A diagnosis of metastatic small intestine tumor in patients with lung cancer is difficult. There are several reports of diagnosis by double-balloon enteroscopy (DBE). Case. A 62-year-old man was admitted because of melena and severe anemia. Chest X-ray also revealed an abnormal pulmonary mass, suggesting lung cancer. Upper and lower gastrointestinal tract endoscopic findings failed to identify the bleeding source. As a result of capsule endoscopy and DBE showed the protruding lesion with an ulcer in the upper jejunum. The histological findings revealed atypical cell, it was poorly differentiated adenocarcinoma with positive for thyroid transcription factor-1 (TTF-1) and PE10 by the examination of immunostaining. Thus, he was diagnosed as primary lung cancer with metastasis to the small intestine. The patient was treated with 4 cycles of cisplatin and pemetrexed combination chemotherapy. Gastrointestinal symptoms were absent throughout the course. The pulmonary disease was not changed. Re-examination by DBE showed decrease of the lesion in the upper jejunum after the chemotherapy, resulting in reduced anemia despite no blood transfusions. Conclusion. This is the first report indicating that DBE is useful for the diagnosis and observation of metastatic small intestine tumors in patients with lung cancer.
key words: Lung adenocarcinoma, Small bowel metastasis, Double-balloon enteroscopy, Capsule endoscope, Chemotherapy
Received: December 16, 2011
Accepted: May 9, 2012
JJLC 52 (3): 310-314, 2012
