title: Oral and gastrointestinal symptomatic metastases as initial presentation of lung cancer.
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.
authors.affiliation: Palliative Care Unit, Christian Medical College Hospital, Vellore, India.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Jeba
authors.affiliation: Department of Radiotherapy, Christian Medical College Hospital, Vellore, India.
authors.forename: Selvamani
authors.initials: S
authors.lastname: Backianathan
authors.affiliation: Department of General Pathology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India.
authors.forename: Gunadala
authors.initials: G
authors.lastname: Ishitha
authors.affiliation: Department of Medical Oncology, Christian Medical College and Hospital, Vellore, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Singh
mesh_terms: D001706:Biopsy; D004379:Duodenal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*; D004386:Duodenum / Q000473:pathology*; D004415:Dyspepsia / Q000175:diagnosis / Q000209:etiology; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008551:Melena / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000556:secondary; D014059:Tongue / Q000473:pathology*; D014062:Tongue Neoplasms / Q000150:complications / Q000175:diagnosis / Q000556:secondary*