Blood-borne metastatic involvement of the stomach by cancer is a rare entity. According to the number of reports in the literature, the most common tumors that spread to the stomach through the blood stream are malignant melanoma, breast carcinoma and lung carcinoma. Recently, two cases of metastatic involvement of the stomach secondary to lung carcinoma were diagnosed by gastroscopy. The first patient was a 66-year-old man who had primary lung carcinoma with multiple bone and subcutaneous metastases. Gastroscopy showed multiple submucosal tumors with central umbilications in the fundus and in the upper body of the stomach. Pathologic examination revealed massive submucosal infiltration and conical shaped and scanty deep mucosal infiltration of undifferentiated small cell carcinoma suggestive of metastatic involvement. The second patient was a 68-year-old man who had primary lung carcinoma with brain metastasis. Gastroscopy showed a large fungating mass in the greater curvature side of the stomach. Pathologic examination revealed poorly differentiated squamous cell carcinoma. We report the two cases of metastatic gastric cancer from lung carcinoma with the literature review.
Aged ; Carcinoma, Small Cell/*secondary ; Carcinoma, Squamous Cell/*secondary ; Humans ; Lung Neoplasms/*pathology ; Male ; Stomach Neoplasms/*secondary

Aged ; Carcinoma, Large Cell ; secondary ; Humans ; Intestinal Neoplasms ; secondary ; Intestine, Small ; pathology ; Lung Neoplasms ; pathology ; Male

Gastric metastasis of lung carcinoma is a rare entity which is detected mostly at autopsy. Patients diagnosed as having those on lifetime are extremely rare. In addition to our case, 54 cases of lung carcinoma metastasis to the gastro-intestinal tract have been reported in the literature since 1961. We report a case of gastric metastasis originated from small cell lung carcinoma. The patient was a 87-year-old man. He refused lung biopsy and further treatment and died 2 months after the diagnosis. This is the case of gastric metastsis originated from lung carcinoma, which was confirmed by immunohistochemical staining.
Aged ; Aged, 80 and over ; Carcinoma, Small Cell/diagnosis/*secondary ; English Abstract ; Humans ; Lung Neoplasms/*pathology ; Male ; Stomach Neoplasms/diagnosis/*secondary

Pancreatic metastases are found in up to 40% of patients with small cell lung cancer, but metastasis-induced acute pancreatitis is rare. Treatment of metastasis-induced acute pancreatitis is initially supportive, but failure of conservative management are common. There are few reports on aggressive treatment with chemotherapy which lead to rapid clinical improvement and prolongation of survival in patients with metastasis-induced acute pancreatitis. We experienced a case of metastasis-induced acute pancreatitis in a patient with small cell lung cancer. Despite conservative treatment with dietary restriction and intravenous fluid supply, serum amylase levels increased persistently with severe abdominal pain. After chemotherapy with irinotecan and carboplatin, abdominal pain and serum amylase levels resolved dramatically.
Acute Disease ; Aged ; Carcinoma, Small Cell/*secondary ; English Abstract ; Humans ; Lung Neoplasms/*pathology ; Male ; Pancreatic Neoplasms/complications/*secondary ; Pancreatitis/*etiology

Acute pancreatitis in cancer patients can be secondary to the malignant process itself or a complication of antineoplastic agent administration. However, acute pancreatitis caused by metastatic carcinoma of the pancreas is an uncommon condition with a poor prognosis. We report a case of a 63-year-old man with small cell carcinoma of the lung, who developed acute pancreatitis lately. Thirteen months earlier, he developed small cell carcinoma of the lung and received 6 cycles of chemotherapy. Abdominal CT scan showed swelling of the pancreas with multiple masses. The patient was managed conservatively and pancreatitis subsided. This case indicates that metastasis induced acute pancreatitis can be a manifestation of lung cancer, especially in small cell carcinoma.
Carcinoma, Small Cell/secondary* ; Carcinoma, Small Cell/radiography ; Carcinoma, Small Cell/pathology ; Case Report ; Human ; Lung Neoplasms/radiography ; Lung Neoplasms/pathology* ; Male ; Middle Age ; Pancreatic Neoplasms/secondary* ; Pancreatitis/radiography ; Pancreatitis/pathology* ; Tomography, X-Ray Computed

OBJECTIVETo report the MRI features of intracranial metastases of lung cancer.

METHODSA total of 858 patients with history of primary lung cancer suspicious of brain metastases was retrospectively reviewed with MRI.

RESULTS1. Of the 858 patients, 393 (45.8%) had brain metastases on MRI. The primary tumor was lung adenocarcinoma in 117 (29.8%), small cell lung cancer in 110 (28.0%), squamous cell cancer in 52 (13.2%), adenosquamous cancer in 16 (4.1%), large cell carcinoma in 2 (0.5%) and carcinoid in 1 (0.3%). The histopathological types of the primary tumor were unknown in 95 (24.2%). 2. Meningeal metastasis was found in 19 patients with lung cancer. The primary tumor was of adenocarcinoma lung in 6, small cell lung cancer in 5, squamous cell carcinoma in 4 and the remaining 4 were of unknown histopathological type. 3. Edema around the lesion: in 120 cases, there was no obvious edema; the edema was slight in 98 cases, moderate in 70, serious in 86.

CONCLUSIONThe brain metastasis of lung cancer is of common occurrence. MRI with enhancement is very helpful in the establishment of diagnosis.

Adenocarcinoma ; diagnosis ; secondary ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; secondary ; Carcinoma, Small Cell ; diagnosis ; secondary ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Magnetic Resonance Imaging ; methods ; Male ; Meningeal Neoplasms ; diagnosis ; secondary ; Middle Aged ; Retrospective Studies

Breast metastases from extramammary neoplasms are very rare. We presented a 66 year-old female with metastasis of small cell lung carcinoma to the breast. She presented with consolidation over the left upper lobe of her lung undetermined after endobronchial or video-assisted thoracoscopic surgery (VATS) biopsy, and this was treated effectively after antibiotic therapy at initial stage. The left breast lumps were noted 4 months later, and she underwent a modified radical mastectomy under the impression of primary breast carcinoma. However, the subsequent chest imaging revealed re-growing mass over the left mediastinum and hilum, and cells with the same morphological and staining features were found from specimens of transbronchial brushing and biopsy. An accurate diagnosis to distinguish a primary breast carcinoma from metastatic one is very important because the therapeutic planning and the outcome between them are different.
Aged ; Breast Neoplasms ; secondary ; Bronchoscopy ; Carcinoma, Small Cell ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology

As multi-modality treatments are now able to ensure better local control and a lower rate of extra-cranial metastasis, brain metastasis has become a major concern in locally advanced non-small cell lung cancer (LA-NSCLC). Prophylactic cranial irradiation (PCI) is now a standard treatment for patients with small cell lung cancer (SCLC), it decreases the incidence of brain metastases and increases the survival rate. Despite the relatively high incidence of brain metastases in LA-NSCLC, the role of PCI in patients treated with radical intent has not been established yet. The objective of this systematic review was to establish whether PCI prevents the development of brain metastasis and increases survival in LA-NSCLC patients, the characteristics of the benefit patients, the tolerance and toxicity, the effective dose and timing of PCI. The main concern in this review is to establish the definitive role of PCI in the treatment of locally advanced NSCLC.
Biomedical Research ; Brain Neoplasms ; prevention & control ; secondary ; Carcinoma, Non-Small-Cell Lung ; prevention & control ; secondary ; Cranial Irradiation ; Humans ; Lung Neoplasms ; Small Cell Lung Carcinoma ; prevention & control ; secondary ; Survival Rate

OBJECTIVETo study the clinicopathologic characteristics of metastatic carcinomas to the spleen.

METHODSSixteen cases of metastatic carcinoma to the spleen were retrieved from archival clinical, surgical pathology and autopsy records. The demographic data (including sex and age of patients), clinical symptoms, primary sites, tumor histologic types, gross appearance of spleen and growth patterns within the spleen were analyzed.

RESULTSAmong the 16 patients studied, 12 were males and 4 were females. The male predilection was obvious. The age ranged from 48 to 90 years, the median age 66.5 years. Major clinical symptoms included discomfort in the left upper quadrant, pain, emaciation and loss of appetite. Splenomegaly was noted in some patients and computerized tomography could show space-occupying lesions in the spleen. In general, lung was the most common primary site for splenic metastasis and accounted for 43.8% of all cases (7/16). In male patients, primary lung tumor was found in 50.0% cases (6/12). On the other hand, primary ovarian tumor was commonly seen in females (2/4). Histologically, undifferentiated carcinoma of lung was frequently encountered (25.0%, 4/16), including 3 cases of small cell undifferentiated carcinoma and 1 case of large cell undifferentiated carcinoma. Other histologic tumor types included bronchioloalveolar carcinoma (2 cases), colonic adenocarcinoma (2 cases), ovarian serous papillary adenocarcinoma (2 cases), and prostatic adenocarcinoma (2 cases). The commonest histologic tumor type found in male patients was pulmonary undifferentiated carcinoma. The growth patterns of metastatic carcinoma in spleen included nodular, diffuse and multinodular. Most cases presented as a single splenic nodule. Sometimes, tumors with high metastatic potential (5/16) showed diffuse and multinodular growth patterns. Examples of these tumors included small cell undifferentiated carcinoma (3 cases), pulmonary adenocarcinoma (1 case) and prostatic adenocarcinoma (1 case).

CONCLUSIONSMetastatic carcinoma to the spleen is rare. Understanding of the clinicopathologic characteristics is helpful in guiding clinical management and pathologic diagnosis.

Adenocarcinoma ; secondary ; Adenocarcinoma, Bronchiolo-Alveolar ; secondary ; Aged ; Aged, 80 and over ; Carcinoma, Small Cell ; secondary ; Colonic Neoplasms ; pathology ; Cystadenocarcinoma, Serous ; secondary ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Ovarian Neoplasms ; pathology ; Prostatic Neoplasms ; pathology ; Spleen ; pathology ; Splenic Neoplasms ; secondary

Intracardiac metastasis as the initial presentation of malignant neoplasm is very rare. We report here on a 64-year-old man with non-small cell lung cancer (NSCLC) initially presenting with intracardiac metastasis which was identified with 18-F fluorodeoxyglucose positron emission tomography (FDG PET). The patient was admitted with complaints of exertional dyspnea and vague chest discomfort that had developed a few weeks ago. Two-dimensional echocardiography revealed a heart mass attached to its akinetic wall in the right ventricular chamber. CT and MRI demonstrated a large tumor involving the epicardium and myocardium in the right ventricle, and there was a mass in the right lower lobe of the lung along with multiple lymphadenopathies. Cytologic examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests, and this was strongly suggestive of squamous cell carcinoma. Subsequent FDG PET confirmed that the intracardiac mass had an abnormally increased FDG uptake, and again this was strongly suggestive of malignancy. By systemically considering these imaging studies, we were able to diagnose the mass as intracardiac metastasis of NSCLC.
Carcinoma, Non-Small-Cell Lung/*diagnosis ; Heart Neoplasms/diagnosis/*secondary ; Heart Ventricles/pathology ; Humans ; Lung Neoplasms/*diagnosis ; Male ; Middle Aged