Colonic metastases from small cell carcinoma of the lung presenting with an acute abdomen: A case report.
BACKGROUND
Colonic metastases are rare, and usually secondary from malignant tumours of the stomach, breast, ovarian, cervix, kidney, lung, prostate, or skin. Around one third are asymptomatic or found only at autopsy.


METHODS
A middle-aged male smoker, who had a small cell carcinoma of the lung diagnosed two years previously and treated with radiotherapy and chemotherapy, was admitted to the emergency room with intense abdominal pain and constipation. With the suspicion of an acute appendicitis he was submitted to surgery. At laparotomy he was found to have a normal appendix but two hard colonic lesions: a mobile one in the right colon and the other fixing the sigmoid colon to the sacrum. A right hemicolectomy and a sigmoid loop colostomy were performed. Pathology showed those lesions to be colonic metastases from small cell carcinoma of the lung.


CONCLUSIONS
Colonic secondaries are most frequently diagnosed in patients who have had a known primary tumour, and may present with bowel obstruction, lower gastrointestinal haemorrhage, gastrointestinal fistula, or intestinal perforation. Presentation with acute abdomen is rare, and survival is usually limited.


CONCLUSIONS
Colonic metastatic disease should be considered in any patient presenting with an acute abdomen and past history of lung malignancy.
Centro Hospitalar de Coimbra, Quinta dos Vales, 3040-801 S. Martinho do Bispo, Coimbra, Portugal. Electronic address: carloscostaalmeida@yahoo.com.
Carlos Eduardo
CE
Costa Almeida
Centro Hospitalar de Coimbra, Quinta dos Vales, 3040-801 S. Martinho do Bispo, Coimbra, Portugal.
Luís Simões
LS
Dos Reis
Centro Hospitalar de Coimbra, Quinta dos Vales, 3040-801 S. Martinho do Bispo, Coimbra, Portugal.
Carlos Manuel
CM
Costa Almeida
Acute abdomen; Bowel obstruction; Colonic metastases; Lung cancer