Author of

• 10923

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  P1.18 - Poster Session 1 - Pathology (ID 175)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pathology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10929

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    P1.18-006 - Clinicopathological features and outcome of gastric metastasis from primary lung cancer: a case report and systematic review (ID 1293)

    09:30 - 09:30  |  Author(s): S. Zhang
    • Abstract

    Background
    Primary lung cancer is one of leading cancer all over the world, while gastric metastasis from lung cancer is extremely rare. We know little about its clinicopathological features, prognosis and treatment strategy.Primary lung cancer is one of leading cancer all over the world, while gastric metastasis from lung cancer is extremely rare. Its clinicopathological features, prognosis and treatment strategy remain largely unknown.

    Methods
    We present a case of primary lung cancer metastasizing to the stomach. Furthermore, we systematically search the Medline database for similar cases from 1966 through 31 December 2012. Data concerning clinicopathological features, treatment strategies and outcomes were extracted and analyzed to explore the nature of gastric metastasis from primary lung cancer.

    Results
    A 61-year-old and asymptomatic woman was admitted for a mass shadow in chest X-ray (Fig A). A right lower lobectomy was performed and pathological examination revealed a poorly differentiated adenocarcinoma. Five months later, gastroscopy showed a mass with deep ulcer in the fungus of the stomach (Fig B). She underwent partial gastrectomy. The HE staining showed the same morphorlogy as the primary lung cancer, and the cancer tissue invaded the submucosa of esophagus and stomach. (Fig C) The diagnosis of gastric metastasis from primary lung cancer was confirmed by positive staining for TTF-1 (Fig D) and CK-7 (Fig E). In the systematic review, we identified 22 eligible cases from 16 articles. The average age at presentation was 67.3 years. There was a male predominance of 90.9% versus 9.1% female. Epigastric pain (45.5%) was the most common chief complaint, following by melena (22.7%), nausea/vomiting(13.6%), and hematemesis(9.1%). Three patients were asymptomic. Five patients firstly went to see doctors for gastrointestinal symptoms. The median time span between the diagnosis of lung cancer and gastric metastasis was 5 months.Endoscopically, gastric lesions are described as nodule or volcano-like ulcer. The body of stomach was the most common site (62.5%) of metastases. Gastric metastasis was reported in adenocarcinoma, squamous-cell cancer, small cell cancer and pleomorphic carcinoma of lung cancer. Comprehensive treatment was the strategy for these patients. The median survival was 4 months, and 1-year postmetastasis survival rate was 35.3%. Three of the five patients who were treated surgically for solitary gastric metastasis survived longer 1 year after detection of metastases.Figure 1

    Conclusion
    Primary lung cancer metastasizing to the stomach is an exceptional event, but doctors should be aware of the possibility. Comprehensive treatment and personalized treatment should be the strategy according to patients’ situation.