Colonic Metastasis from a Primary Adenocarcinoma of the Lung Presenting with Acute Abdominal Pain: A Case Report

以急性腹痛來表現的原發性肺腺癌合併大腸轉移

翁銘偉(Ming-Wei Weng)；王鴻昌(Hong-Chung Wang)；邱仁治(Jen-Chih Chiou)；林秀玲(Shong-Ling Lin)；賴瑞生(Ruay-Sheng Lai)

大腸轉移 ； 免疫組織染色 ； 肺腺癌 ； colonic metastasis ； immunohistochemistry ； lung adenocarcinoma

The Kaohsiung Journal of Medical Sciences

26卷1期（2010 / 01 / 01）

40 - 44

英文

肺癌合併大腸轉移是很罕見的，且通常臨床表現不會有明顯症狀。在此我們報告一個罕見案例，原發性肺腺癌合併大腸轉移病例，以類似腸阻塞之急性腹痛來表現，臨床上可能誤診斷為大腸癌合併多處轉移。病患接受緊急大腸鏡檢查及切片，及後續接受腹部手術及肺部支氣管鏡切片檢查的病理報告結果一致是肺腺癌。進一步在免疫組織染色研究上證實肺腺癌合併大腸轉移，其二者均表現TTF-1及CK7呈陽性，而CK20及CDX-2呈陰性。

Colonic metastasis from lung cancer is rare and generally asymptomatic. Here, we report a case with lung adenocarcinoma that presented with acute abdominal pain due to intestinal obstruction caused by the metastatic colon tumor. The patient underwent emergency colonoscopy and the pathologic report was adenocarcinoma, which was the same as that for a bronchoscopic biopsy from a large lung mass. Immunohistochemistry was positive for thyroid transcription factor-1 and cytokeratin 7, and negative for cytokeratin 20 and caudal-related homeobox transcription factor 2 on both lung biopsy and colon surgical specimens. Accordingly, we used immunohistochemistry for thyroid transcription factor-1, cytokeratin 7, cytokeratin 20 and caudal-related homeobox transcription factor-2 to diagnose primary adenocarcinoma of the lung with colonic metastasis.