title: Gastrointestinal Fistula as First Presentation of Lung Cancer.
abstract: The initial manifestation of lung cancer as gastrointestinal tract metastasis is an extremely rare event. In most cases, these metastases are diagnosed after the primary lung tumor, when potentially life-threatening complications develop, often requiring emergency surgery. Regardless of treatment, these patients have a poor prognosis, due to the advanced stage of their disease. We report a clinical case of a gastrointestinal fistula arising from a small bowel non-small cell lung cancer (NSCLC) metastasis as a first manifestation of the disease, in a 43-years-old man. He underwent laparatomy with segmental small bowel and colon resection, followed by pulmonary lobectomy. A few months later the patient presented a cerebellum metastasis and was submitted to metastasectomy and holocranial radiation. After that event, systemic chemotherapy was prescribed, due to bone metastasis. Twenty-nine month after diagnosis, the patient is alive with a stable general condition. Aggressive surgical treatment of both primary and metastatic tumors can provide palliation and may improve short-term survival.
authors.affiliation: Serviço de Cirurgia Torácica do Hospital de Pulido Valente, Centro Hospitalar Lisboa Norte, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Barata
authors.forename: Magda
authors.initials: M
authors.lastname: Alvoeiro
authors.forename: Telma
authors.initials: T
authors.lastname: Calado
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodrigues
authors.forename: Francisco
authors.initials: F
authors.lastname: Félix