Journal List > Tuberc Respir Dis > v.63(3) > 1001144

Yoo, Sim, Lee, Shim, Chang, Kim, and Sung: A Case of Duodenal Metastasis from Adenocarcinoma of the Lung

Abstract

A gastrointestinal metastasis from lung cancer is rare and is quite often found during an autopsy. A 58-year-old man was admitted with left upper back pain and a mass in the left upper lobe on the chest radiograph. The transbronchial lung biopsy revealed an adenocarcinoma of the lung. A gastroduodenoscopy was carried out to evaluate the indigestion and epigastric discomfort. The duodenofibroscopy revealed bulging mucosa on the minor papilla of the duodenum. A metastasis to the duodenum from an adenocarcinoma of the lung was diagnosed by a duodenofibroscopic biopsy of the bulging lesion. We report this rare case of an adenocarcinoma of lung with a metastasis to the duodenum.

Figures and Tables

Figure 1
Chest radiograph shows increased radioopacities in left upper lobe and left hilar area.
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Figure 2
Computed tomogram of the chest shows a 4.7 cm-sized mass in the left upper lobe with invasion of chest wall including left 3rd rib (A) and an about 6.3-cm sized conglomerated mass in the left hilar area (B).
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Figure 3
F18-FDG positron emission tomogram of whole body shows a large intense FDG-uptaked mass in left upper lung (SUV max 17.7), intense hypermetabolic lymphadenopathy at left hilar, aortopulmonary window, paraaortic, highest mediastinum, and supraclavicular area. A large hypermetabolic mass in the left adrenal gland and a focal increased FDG uptake at the right axilla were also noted.
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Figure 4
Bronchoscopy shows extrinsic compression around the orifice of apicoposterior segmental bronchus of the left upper lobe
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Figure 5
Gastroduodenoscopy shows bulging mucosa on the minor papilla of the duodenum.
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Figure 6
(A) Transbronchial lung biopsy shows adenocarcinoma. (H&E, ×100) (B) Gastroduodenoscopic biopsy of the duodenum shows stromal infiltration of markedly atypical epithelial cells, consistent with adenocarcinma. (H&E, ×100) (C) Cancer tissue of the duodenum shows positive immunostaining for thyroid transcription factor-1 (TTF-1) for differentiating pulmonary adenocarcinoma from non-pulmonary adenocarcinoma. (TTF-1 stain, ×100)
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