Lung cancer with gastrointestinal metastasis - review of theories of metastasis with three rare case descriptions

Craniopharyngioma in young female patient occurring after ovarian teratoma removal - A case report

INTRODUCTION

Craniopharyngiomas are rare, benign brain tumors derived from Rathke's pouch epithelium, typically manifesting with symptoms like visual impairment and endocrine issues. While standard treatment involves surgery and radiotherapy, such approaches are limited in resource-poor settings, resulting in complex management challenges. To describe the occurrence of craniopharyngioma in a young female patient following the surgical removal of an ovarian teratoma, exploring possible associations and clinical implications.

CASE PRESENTATION

A 22-year-old woman presented with abdominal pain, distention, visual disturbances, and recent right eyelid ptosis. Her history includes an ovarian teratoma removal, and physical exams revealed hepatomegaly, ascites, and bilateral edema. Imaging showed a suprasellar mass consistent with craniopharyngioma, though histological confirmation was unavailable. Limited resources precluded optimal management, prompting palliative treatment.

CLINICAL DISCUSSION

This case highlights the difficulty of diagnosing and managing craniopharyngiomas in low-resource settings with limited advanced imaging and biopsy options. Abdominal malignancy nodules suggest metastasis, a rare but severe complication.

CONCLUSION

Craniopharyngioma diagnosis and treatment are challenging in Somalia due to limited resources. Palliative care is often the main option. Strengthening diagnostics and palliative care can improve outcomes.

Small cell lung carcinoma metastatic to the stomach: Commonly overlooked, limited treatment options

Small cell lung carcinoma metastatic to the stomach, whether synchronous or metachronous, is a rare phenomenon accounting for < 0.5% of lung cancers. Hence it can be overlooked by clinicians resulting in delayed diagnosis. This manuscript comments on Yang et al's article which reported 3 such cases. The main diagnostic features are based on routine morphology comprised of small cells with hyperchromatic nuclei, scant cytoplasm, brisk mitoses and necrosis. This can be supplemented by immunohistochemistry demonstrating positivity for cytokeratin, thyroid transcription factor-1 and neuroendocrine markers as well as a high Ki-67 labelling index. Imaging modalities such as positron emission tomography/contrast computed tomography help to confirm lung origin and rule out the possibility of extra-pulmonary small cell carcinoma. The predominant mechanism of spread is most likely hematogeneous. Prognosis is generally poor since this represents stage 4 disease but survival can be improved by chemo/radiotherapy and palliative surgery in select cases. Though outcomes have not changed much in the last several decades, the recent Food and Drug Administration approval of immune checkpoint inhibitors was a significant milestone as was the delineation of small cell lung carcinoma molecular subtypes. Liquid biopsies are increasingly being used for biomarker studies in clinical trials to assess treatment response and prognosis.

Isolated sigmoid colon metastasis from lung micropapillary adenocarcinoma: a case report

Lung cancer is a common malignant neoplasm that is prone to distant metastasis. Gastrointestinal metastasis from lung cancer is rather rare no matter what stage. Herein, we presented a case of pulmonary adenocarcinoma six months after thoracoscopic Lobectomy isolated metastasis to sigmoid colon. Then the patient underwent radical resection of metastatic tumors of sigmoid colon. The pathologic morphology and immunohistochemistry of lung adenocarcinoma is highly consistent with the sigmoid colon tumor and their gene profiles are likely similar expect for an AXIN1 mutation in primary tumor and not in the metastatic lesion.

Rare Metastatic Sites of a Lung Adenocarcinoma

We report a rare case of a lung adenocarcinoma presenting with chylothorax and metastases to the common bile duct and the rectum. From the radiological and endoscopic appearance of the tumors, the main differential diagnoses were metastatic lung cancer to multiple rare extra-thoracic sites and multiple synchronous primary oncological malignancies. Pathological examination of the biopsies with positive immunohistochemical staining for thyroid transcription factor-1 (TTF-1) played an important role in confirming metastatic pulmonary adenocarcinoma.

Disseminated lung cancer presenting as a rectal mass

Primary lung cancer is the leading cause of cancer-related deaths globally, and approximately 50% had metastatic disease at the time of diagnosis. A rectal mass and unintended weight loss are common manifestations of rectal cancer. Our case presented with a rectal mass, but workup revealed a metastatic lesion from lung cancer. Lung cancer metastases to the lower gastrointestinal tract imply reduced survival compared with the already poor mean survival of stage IV lung cancer. Despite relevant therapy, the patient died 5 months after referral.

Long-term survival of a patient with metachronous rectal metastasis from primary cecal cancer who underwent repetitive resection and chemotherapy: a case report

There are few reported cases of colorectal metastasis from cancers of other organs, particularly other segments of the colon. Here we describe the long-term survival of a 68-year-old male patient with metachronous rectal metastasis from cecal cancer who underwent repetitive resection and chemotherapy. The patient underwent ileocecal resection and hepatectomy for cecal cancer with liver metastasis (T3, N1a, M1a, Stage IVA) in 2006. The patient subsequently underwent splenectomy for splenic metastasis in 2007. In August 2008, barium enema revealed compression of the rectal wall, and abdominal computed tomography (CT) detected a mass along the rectum extending into the pelvis. Rectal metastasis from cecal cancer was suspected and Hartmann’s operation with bilateral seminal vesicle dissection was performed. Histological examination of the excised tumor revealed moderately differentiated adenocarcinoma formed in the muscularis propria of the rectum and infiltrating the connective tissue between the seminal vesicle and rectum. However, no tumor was detected in the rectal mucosa or submucosa. These histological findings supported the diagnosis of rectal metastasis from cecal cancer. The patient has been monitored at our clinic for 60 months after surgical removal of the rectal metastasis. The findings from this case should alert oncologists to the potential danger of rectal metastasis from primary colon cancer and the benefits of timely complete resection in terms of improved patient outcomes.

Regression of metastatic colon tumour from primary adenocarcinoma of the lung due to fistulisation to the bowel lumen

An 80-year-old Japanese male was diagnosed with pulmonary adenocarcinoma. The patient exhibited extensive extra pulmonary involvement in the bone, adrenal gland, abdominal lymph nodes, and sigmoid colon. A single course of chemotherapy with carboplatin and pemetrexed was administered as the first-line treatment. Subsequently, the patient received pemetrexed monotherapy. Two months after the diagnosis, rapid regression of the metastatic tumour in the sigmoid colon was observed. Based on the findings of CT scanning and colonoscopic examination, tumour-bowel fistulisation was considered to be a cause of the rapid regression. This case report illustrates a tumour-bowel fistula of a colonic metastatic tumour in a patient with lung cancer. Radiographic and endoscopic features of the rare manifestation are presented.