Oral and gastrointestinal symptomatic metastases as initial presentation of lung cancer

BMJ Case Rep. 2016 Nov 18:2016:bcr2016217539. doi: 10.1136/bcr-2016-217539.

Abstract

Metastasis to the tongue, duodenum or pancreas from primary lung cancer is uncommon. Primary lung cancer presenting with symptoms related to metastases at these sites, at initial presentation is extremely rare. We report a 45-year-old man with disseminated lung malignancy who presented with dyspepsia, melena, symptoms due to anaemia and swelling in the tongue. Oral examination revealed a hard submucosal anterior tongue lesion. Biopsies from the tongue lesion and the duodenal ulcer seen on upper gastrointestinal endoscopy were suggestive of metastasis from lung primary. CT revealed lung primary with disseminated metastasis to lung, liver, adrenals, kidneys, head and body of pancreas, duodenum and intra-abdominal lymph nodes. The patient was treated with palliative chemotherapy. The unusual presentation and diagnostic details are discussed.

Publication types

  • Case Reports

MeSH terms

  • Biopsy
  • Duodenal Neoplasms / complications
  • Duodenal Neoplasms / diagnosis
  • Duodenal Neoplasms / secondary*
  • Duodenum / pathology*
  • Dyspepsia / diagnosis
  • Dyspepsia / etiology
  • Gastrointestinal Neoplasms / complications
  • Gastrointestinal Neoplasms / diagnosis
  • Gastrointestinal Neoplasms / secondary
  • Humans
  • Lung Neoplasms / pathology*
  • Male
  • Melena / diagnosis
  • Melena / etiology
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / secondary
  • Tongue / pathology*
  • Tongue Neoplasms / complications
  • Tongue Neoplasms / diagnosis
  • Tongue Neoplasms / secondary*