- 期刊
Gastrointestinal Metastases from Lung Cancer: Report of a Case
肺癌之腸胃道轉移：一病例報告及文獻回顧
摘要
癌症轉移至胃腸道為一罕見之疾病。我們報告一例肺癌病患，發生胃腸道轉移的病例。這位36歲男性病患，18年前曾有消化性潰瘍穿孔，而接受Billroth 11亞全胃切除的病史。在住院前一個月，因發現一右上肺葉腫瘤，在本院接右上肺葉切除。本次因腸阻塞而住進本院。住院後因為病況未改善，而於住院後7日，接受剖腹探查剖。術中發現在迴腸有兩處因腫瘤引起的腸套疊，另在空腸發現多發腫瘤。術後13天，又因發生上消化道出血，而接受上消化道內視鏡檢查，發現胃與近端小腸有多發性息肉狀腫瘤及一火山口樣腫瘤。組織學檢查，發現切下的小腸腫瘤、胃的內視鏡生檢、與前次手術的肺腫瘤，細胞型態相同，且發生於胃腸道的粘膜下層，證實為一肺癌腸道轉移病例。我們回顧文獻，對此疾病之臨床要點及內視鏡所見作一探討。
並列摘要
The gastrointestinal tract is a rare site of metastatic spread. A case of lung cancer with gastrointestinal metastases was reported. This 36-year-old patient had a history of perforated peptic ulcer and was treated with a Billroth II subtotal gastrectomy 18 years ago. He was found to have a right upper lobe lung mass and received lobectomy in our hospital one month prior this admission. He was readmitted to the hospital because of intestinal obstruction. Due to persisting symptoms, a laparotomy was performed 7 days after admission. Two ileal tumors causing intussusceptions of the ileum at two different sites and multiple jejunal tumors were found. Thirteen days after the operation, the patient developed episodes of upper gastrointestinal bleeding. Panendoscopy showed multiple polypoid tumors and one ”volcano-like” lesion in the remnant of stomach and proximal intestine. Histologic examination of the resected tumors from the small bowel, endoscopic biopsy from the stomach, and the previously resected tumor from the lung revealed similar cancer cell morphology. The cancer cells were also found mainly involving the submucosal layer of the gastrointestinal tract. These suggested the diagnosis of lung cancer with gastrointestianl metastases. We review the clinical presentation and endoscopic findings of this unusual condition.
延伸閱讀
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