A Case of Lung Cancer Metastasis to the Colon which Differed from the Primary Tumor in that it was a Spindle Cell Carcinoma

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 10; pp. 2817 - 2823
• Main Authors: KURAYOSHI, Manabu, TOYOTA, Kazuhiro, SADAMOTO, Seiji, TOKUMOTO, Noriaki, TAKAHASHI, Tadateru, MANDAI, Koichi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2014
• Subjects: colon metastasis; lung cancer; spindle cell carcinoma
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.2817

An 80-year-old man was admitted to our hospital with left lower abdominal pain 1 year and 5 months after surgery for left lung cancer (poorly differentiated adenocarcinoma, Stage IB). Abdominal computed tomography showed a sigmoid colon tumor with extramural invasion of the mesentery and transverse colon. Colonoscopy showed an elevated lesion, similar to a submucosal tumor, in the sigmoid colon. A gastrointestinal stromal tumor was suspected, and left hemicolectomy was performed. Analysis of the resected specimen indicated a 10 × 10 cm sarcomatoid tumor in the sigmoid colon that invaded the mesentery and transverse colon. Pathological examination of the tumor indicated spindle cell carcinoma. Immunohistochemical analysis of the tumor indicated that it was CK7 positive, and CK20 negative. Therefore, we diagnosed colon metastasis from lung cancer. Lung metastasis and pelvic recurrence were detected 3 months after the operation and the patient died 5 months after the operation. Colon metastasis from lung cancer is rare, and spindle cell carcinoma is extremely rare. We report this case with reference to the relevant literature.