A case of pleomorphic carcinoma with jejunum mesenterium metastasis

Background. Pleomorphic carcinoma of the lung is a rare primary pulmonary malignancy and has a poor prognosis. Lung cancer has a low frequency of metastasis to the gastrointestinal tract to the metastasis (8.8%), but some reported that pleomorphic carcinoma of lung has relatively higher gastrointestinal tract metastasis compared to other lung cancer. Case. A 59-year-old man presented with an abnormal chest shadow. He underwent bronchoscopy and non-small cell lung carcinoma was diagnosed. The tumor was completely resected in May 2006, with right upper lobectomy and lymph node resection. The definitive pathological diagnosis was pleomorphic carcinoma of the lung, pathological stage IB. In July 2007, he had a low fever and elevated tumor marker (SCC), PET scan revealed upper abdominal tumor with 15 cm in with no abdominal symptoms. The abdominal tumor was resected and was diagnosed as mesenterium metastasis. Systemic chemotherapy was planned but without having chemotherapy his disease progressed and he died within 3 months with multiple organ dysfunction. Conclusion. We studied metastasis in 30 cases of pleomorphic carcinoma of the lung reported in Japan after 1999 at the time of the WHO revision. Twenty cases with 46 metastases were reported and the highest was gastrointestinal tract metastasis (20%) much higher than that of lung cancer in general (8.8%). Cases of gastrointestinal tract metastasis often present with acute abdomen, therefore it is recommended that abdominal symptoms should be carefully observed during the follow-up of pleomorphic carcinoma of the lung.