Duodenal Metastases from Lung Carcinoma.

A 67-year-old man was admitted to our hospital with a month history of upper abdominal pain and weight loss of 6 kg. Gastrointestinal endoscopy showed multiple umbilicated polypoid lesions: 2 lesions in the stomach (Picture 1A), 3 lesions in the duodenum (Picture 1B), and multiple lesions in the colon. Computed tomography revealed mass lesions in the right lung and adrenal gland, as well as hilar, mediastinal, and intra-abdominal lymphadenopathy. A examination of gastrointestinal biopsy samples revealed poorly differentiated adenocarcinoma positive for both thyroid transcription factor-1 (Picture 2A) and cytokeratin 7 (Picture 2B), both known to be immunohistochemical markers of lung adenocarcinoma. Therefore, this patient was diagnosed with multiple gastrointestinal metastases from lung adenocarcinoma. The incidence of duodenal metastasis in duodenal malignant tumors was reported to be only 6% in studies of autopsies (1), and duodenal metastasis from lung adenocarcinoma is an extremely rare entity (2).

Picture 1.

Picture 2.