![]() ![]() He received MIC chemotherapy, but eventually died 6 months later due to respiratory failure, from a combination of disease progression and a chest infection. A curative resection was not possible and he was referred to the local oncology service for further treatment. He was bronchoscopically operable, however at thoracotomy the tumour was found to be adherent to the pericardium, invading the inferior pulmonary vein and there was an additional tumour in the right upper lobe, this represented T4 disease. Two months later, he underwent a bronchoscopy and right lateral thoracotomy with a view to resection of his lung primary. a moderately differentiated squamous cell carcinoma demonstrating brisk stromal desmoplasia. All 10 lymph nodes sampled were free from tumour which had similar histology to the bronchial biopsy, i.e. A grey nodule 1 cm in diameter was also seen, which contained poorly differentiated squamous cell carcinoma of the large cell non-keratinising pattern. The pathology specimen demonstrated diffuse diverticulosis with irregular mucosal thickening with a focal perforation and paracolic abscess. All other organs were normal at the time of laparotomy, and he made an unremarkable post-operative recovery. In view of his symptomatic colonic disease he underwent a sigmoid colectomy for resection of his presumed colonic diverticular mass 4 weeks later. Pulmonary function tests and the patients general condition were acceptable for pneumonectomy to be tolerated.ĬT scan showing mass in right lower lobe. These appearances were consistent with an anatomically resectable lung lesion. This confirmed a 4 cm mass in the right lower lobe, occluding the right lower lobe bronchus and associated with distal consolidation, with no evidence of mediastinal involvement (see Fig. Computed tomography (CT), requested urgently was performed 4 weeks later. ![]() This yielded biopsies which were consistent with a squamous cell carcinoma. Bronchoscopy was requested urgently and performed 4 weeks later. A chest radiograph showed an opacity in the right lower zone. Clinical evaluation revealed reduced air entry at the right base, with dullness to percussion and a monophonic wheeze. He complained of exertional dyspnoea and a change in the character of his voice. Six weeks later, the patient was admitted as an emergency under the chest physicians with haemoptysis. The patient was scheduled to have elective laparotomy and large bowel resection. Colonoscopy revealed a polypoid lesion at 25 cm with a proximal stricture, which had macroscopic features of malignancy, however this was not confirmed on biopsy, and a preliminary diagnosis of stricture secondary to diverticulosis was made. A routine chest X-ray was reported as normal. Routine biochemical and haematological profiles were within physiological limits. He had a significant previous smoking history of 50 pack years but had not smoked for many years.Ĭlinical evaluation, including rectal examination, was unremarkable. He complained of passing 12 stools per day with mucus but no frank blood loss, and also of losing almost 4 kg in weight. 2 Case reportĪ 68-year-old man was referred to the gastroenterology department by his general practitioner with a 4 month history of diarrhoea and weight loss. ![]() Here, we present a case in the literature of a symptomatic colonic metastasis from a squamous cell carcinoma of the lung. In the past 20 years only 11 cases of symptomatic colonic metastases from lung malignancies of all types have been reported in the literature. Lung cancer is the most common malignancy in the UK, however metastasis to the colon is very rare. Lung cancer, Colonic metastasis 1 Introduction
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |