A CASE OF SMALL INTESTINE METASTASIS FROM LUNG CANCER

Lung cancer can easily metastasize because of its anatomical features, but the metastasis to the small intestine is very rare and only 124 cases included this case can be seen in Japan.A 75-year-old male was admitted because of abdominal pain and vomiting. Chest X-ray film showed a tumor shadow (3.5×3.5 cm) in the right upper lung field, and abdominal X-ray findings showed a free air in the infra-diaphragma and abnormal gas of the small intestine. A diagnosis of perforation of a alimentary tract was made, operation being performed. There was a hen's egg sized tumor in the ileum 2 m orally from ileum end, in which φ3 mm perforation could be seen at the center. small intestine resection (about 60 cm) with the tumor and end-to-end anastomosis were carried out. Histological finding showed a poorly differentiated adenocarcinoma metastasized from lung cancer.In a one month period after operation right pleural effusion was seen because of plueral metastasis, and abdominal CT revealed probable metastatic tumors of both adrenal glands. Unfortunately he died on the 47th day after operation.