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Vol.59 No.5 contents | Japanese/English |
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- Case Report -
A Case of a Recurrence-free Survival for Eight Years After Surgical Resection of Small Bowel Metastasis of Lung Cancer
Tomoyuki Kawamura1, Moriyuki Kiyoshima1, Hisashi Suzuki1, Takayuki Kaburagi2, Tatsuo Iijima31Department of Thoracic Surgery, 2Department of Respiratory Medicine, 3Department of Diagnostic Pathology, Ibaraki Prefectural Central Hospital, Japan
Background. Metastasis of lung cancer to the small bowel has a poor prognosis, and the long-term survival is rare. We herein report a case in which a long-term survival without recurrence was obtained with only surgery for small bowel and mesenteric lymph node metastases. Case. A 57-year-old man underwent right upper lobectomy with right hilar and mediastinal lymph node dissection for right upper lobe cancer. On pathology, a diagnosis of lung adenocarcinoma pT3N0M0 stage IIB was made. Postoperative adjuvant chemotherapy was not initiated. The patient presented with gastrointestinal bleeding three years later. Abdominal computed tomography (CT) revealed a small bowel tumor that was suspected of being lung cancer metastasis. Partial resection of the small bowel tumor and mesenteric lymph nodes was performed. On pathology, a diagnosis of small bowel metastasis of lung cancer was made. In both the lung and small bowel, infiltration of tumor cells with inflammatory CD8 T cells was observed. Postoperative chemotherapy was not initiated. The patient remains alive without recurrence 11 years after surgery for lung cancer and 8 years after surgery for small bowel metastasis. Conclusion. Small bowel and mesenteric lymph node metastases of lung cancer has a poor prognosis. This case was considered to be at a high risk of recurrence; however, the patient survived for a long time without recurrence with surgical treatment alone. A large number of lymphocyte infiltrates were observed in the tumor, and the tumor immune response may be related to this good outcome.
key words: Adenocarcinoma, Small bowel metastasis, Long-term survival, Lymphocyte infiltration
Received: May 15, 2019
Accepted: August 23, 2019
JJLC 59 (5): 490-496, 2019
