METASTATIC LARGE-CELL LUNG-CARCINOMA PRESENTING AS GASTROINTESTINAL HEMORRHAGE

A rare case of severe small bowel hemorrhage due to jejunal metastases from a large-cell type carcinoma of the lung is reported, A 69-yr-old Japanese woman presented with complaints of mild abdominal pain and l iquid tarry stools 6 months following surgery for lung carcinoma, Gast roduodenoscopy and barium enema yielded unremarkable findings, althoug h a subsequent small bowel enema revealed a large, 15-cm ulcerated mas s in the jejunum. This tumor was resected and histology confirmed to b e consistent with a metastasis from the primary undifferentiated large -cell carcinoma of the lung, The patient had an uneventful postoperati ve course and survived for 9 months. There have been only two prior ea se reports of major intestinal hemorrhage secondary to pulmonary carci noma metastases in the English literature. Previous reports of such me tastases of the small bowel have documented a very poor-prognosis and our patient demonstrated the longest survival period to date, The clin ical course of this patient suggests that the early diagnosis and pall iative surgery for this complication provide a more favourable outcome .