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      A Case of Primary Lung Adenocarcinoma With Metastasis to Colon Harboring EGFR Exon 19 Deletion

      case-report
      Author(s): 1 , , 1 , 1
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: immuno-histochemical, genomic analysis, adenocarcinoma of colon, pulmonary adenocarcinoma, metastasis from primary lung, egfr exon 19 mutation

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          Abstract

          Lung cancer metastasizing to the colon is exceedingly rare and can present similarly to colorectal cancer. It is crucial to conduct further evaluations using immunohistochemical (IHC) stains and genomic testing to differentiate between the two and provide appropriate treatment without delay. Lung cancer generally has a poor prognosis, especially in cases with distant metastases. Although gastrointestinal (GI) metastases from lung cancer have been reported, cases of lung cancer manifesting as colon metastasis are extremely rare, with only a few instances documented.

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          Most cited references15

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          Specific organ metastases and survival in metastatic non-small-cell lung cancer.

          Hiroichi Ishikawa, Katsunori Kagohashi, Nobuyuki Hizawa … (2015)
          The present retrospective study was performed to evaluate the clinicopathological characteristics associated with distant metastasis from non-small-cell lung cancer (NSCLC). The records of NSCLC patients with metastasis at the time of diagnosis between 1999 and 2012 were reviewed. Of the consecutive 1,542 NSCLC patients diagnosed during the study period, 729 (47.3%) patients presented with distant metastasis. Among those 729 metastatic NSCLC patients, 250 (34.3%), 234 (32.1%), 207 (28.4%), 122 (16.7%), 98 (13.4%) and 69 (9.5%) had bone, lung, brain, adrenal gland, liver and extrathoracic lymph node metastasis, respectively. In a multivariate analysis using the Cox proportional hazards model, liver and adrenal gland metastases were unfavorable prognostic factors. However, brain and bone metastases were not statistically significant prognostic factors. Using a logistic regression analysis, metastasis to the adrenal glands and the presence of pleural and/or pericardial fluid effusion were correlated with a poor performance status. Therefore, when planning the treatment of NSCLC patients, particularly those with liver and adrenal gland metastases, we should take into consideration information regarding these unfavorable organ metastases.
          Article 0 comments Cited 139 times – based on 0 reviews     Review now
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            Gastro-intestinal metastasis of primary lung carcinoma: clinical presentations and outcome.

            Inn-Wen Chong, Chih-Jen Yang, Chau-Chyun Sheu … (2006)
            Symptomatic gastro-intestinal (GI) metastasis in lung carcinomas is extremely rare and only a few case reports have been published. Here we review all of the cases of lung cancer from January 2003 to April 2005 in a tertiary teaching hospital in Taiwan. A total of six patients (1.77%, 6/339) with primary lung cancer demonstrated symptomatic gastro-intestinal metastasis. Three patients had squamous cell carcinoma, one had adenocarcinoma, and two had small cell carcinoma. Three patients with gastric metastasis were diagnosed via gastro-endoscopy while one with cecal involvement was diagnosed via colon fiberscopy. Two patients with small bowel perforation and intussusception were diagnosed via laparotomy. We presented these rare cases and made a review of the literature.
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              Small bowel metastases from primary carcinoma of the lung.

              Lawrence D. Wagman, Elizabeth McNeill, J Neifeld (1987)
              Although about half of all patients with carcinoma of the lung have metastases at initial presentation, only nine with metastases to the small bowel have been previously reported. This study was performed to determine the incidence of occult and clinically apparent metastases of lung cancer to the small intestine. Small bowel metastases were present in 46 of 431 patients with primary lung cancer who underwent autopsy during an 11-year period. These patients had an average of 4.8 metastatic sites. Small bowel metastases were present in 12 of 31 (39.0%) patients with large cell carcinoma, 13 of 108 (12.3%) with adenocarcinoma, six of 73 (8.0%) with small cell carcinoma, 15 of 199 (7.5%) with squamous cell carcinoma, and none of 20 with undifferentiated carcinoma. During the same interval, six of 78 patients undergoing small bowel resection for metastatic tumor had lung cancer primaries. Among the nine previously reported clinical cases of small bowel metastases and the six in this series, 14 were operated upon for small bowel perforation and one for obstruction. Nine patients died perioperatively, and no patient survived longer than 16 weeks. These data demonstrate that the incidence of lung cancer metastases to the small bowel is higher than is clinically apparent. Lung cancer metastases to the small bowel often present as intestinal perforation and indicate a poor prognosis; surgery is indicated for palliation.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 2 July 2024
                Publication date (Electronic, collection): July 2024
                Volume: 16
                Issue: 7
                Electronic Location Identifier: e63665
                Affiliations
                [1 ] Internal Medicine, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, USA
                Author notes
                Article
                DOI: 10.7759/cureus.63665
                PMC ID: 11218848
                PubMed ID: 38957515
                SO-VID: 54cdcb8b-06dc-4353-88f9-851c9ed16f73
                Copyright © Copyright © 2024, Lin et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 2 July 2024
                Categories
                Subject: Gastroenterology
                Subject: Oncology
                Subject: Pulmonology

                Keywords: immuno-histochemical,genomic analysis,adenocarcinoma of colon,pulmonary adenocarcinoma,metastasis from primary lung,egfr exon 19 mutation
                Data availability:
                Keywords: immuno-histochemical, genomic analysis, adenocarcinoma of colon, pulmonary adenocarcinoma, metastasis from primary lung, egfr exon 19 mutation

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