Long-term survival in a patient with non-small cell lung cancer presenting as small intestinal obstruction

Despite the early and widespread dissemination of nonsmall cell lung cancer, clinically significant metastases in the small bowel are rare, and when they do occur, the patient is almost always in the terminal stages of the disease.

We report on a patient who presented initially with small bowel obstruction resulting from metastatic spread of a squamous cell carcinoma of the lung. Following surgical removal of the affected bowel, the patient underwent radiofrequency ablation of the lung tumor and subsequent lower lobe resection. The patient continues to be free of disease 2 years from the initial diagnosis.

This report highlights the need for a timely diagnosis of an acute surgical abdomen and for the inclusion of small intestinal metastases in the differential diagnosis of the acute abdomen in a patient with a lung cancer. Resection of the obstructing tumor and postoperative systemic therapy should be considered. In cases of isolated metastases, resection of the primary lung tumor is indicated.