Rare Occurrence of Gastric and Gallbladder Metastases in Non-Small Cell Lung Carcinoma: A Case Report

Background: Gastrointestinal metastasis from non-small cell lung carcinoma (NSCLC) is rare and complex. Although NSCLC primarily affects the lungs, it can metastasize to the gastrointestinal tract, with gastric and gallbladder involvement being especially uncommon. This rarity complicates diagnosis, as it often mimics benign conditions, potentially delaying treatment. Symptoms can include perforation, hemorrhage, and obstruction, though many patients are asymptomatic. Endoscopy, CT, and PET scans are critical for accurate diagnosis. Despite diagnostic and treatment advancements, the prognosis for NSCLC patients with gastrointestinal metastasis remains poor [1] [2] [3] [4].

Case Presentation: This report describes an 80-year-old female with Stage IVB NSCLC, who developed new abdominal symptoms. A routine surveillance PET scan revealed a new hypermetabolic lesion at the lesser curvature of the stomach and a distended gallbladder. Subsequent esophagogastroduodenoscopy and surgery identified a gastric ulcer and an inflamed gallbladder which were biopsied and removed. Histopathological examination revealed adenocarcinoma. Immunohistochemical staining (CK7, CK20, TTF1, and Napsin A) confirmed the diagnosis of gastric and gallbladder metastases from primary lung cancer.

Discussion: This case highlights diagnosing GMLC's clinical challenge due to its rarity and non-specific symptoms. Heightened clinical awareness and comprehensive diagnostics are crucial for NSCLC patients with new gastrointestinal symptoms. Understanding clinical presentations, diagnostic challenges, and management strategies for NSCLC gastrointestinal metastases are vital for improving outcomes and guiding future research.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Antler AS, Ough Y, Pitchumoni CS, Davidian M, Thelmo W.. Gastrointestinal metastases from malignant tumors of the lung. Cancer 1982; 49: 170-172
• 2 Yamamoto M, Matsuzaki K, Kusumoto H, Uchida H, Mine H, Kabashima A, Maehara Y, Sugimachi K.. Gastric metastasis from lung carcinoma. Case report. Hepatogastroenterology 2002; 49: 363-365
• 3 Rossi G, Marchioni A, Romagnani E, Bertolini F, Longo L, Cavazza A, Barbieri F.. Primary lung cancer presenting with gastrointestinal tract involvement: Clinicopathologic and immunohistochemical features in a series of 18 consecutive cases. J Thorac Oncol 2007; 2: 115-120
• 4 Hu Y, Feit N, Huang Y, Xu W, Zheng S, Li X.. Gastrointestinal metastasis of primary lung cancer: An analysis of 366 cases. Oncol Lett 2018; 15 (6): 9766-9776