Work

Multiple small intestinal metastatic tumours: from basics to advanced testing

Year: 2025

Type: article

Abstract: We report the case of a patient with 13 metastatic small bowel tumours presenting with upper gastrointestinal bleeding. He had a video-assisted thoracoscopic left upper lobectomy a year previously for a lung adenocarcinoma. Histological findings of the resected small bowel confirmed a poorly differentiated anaplastic adenocarcinoma (pT3 N1 Mx). Molecular testing on the tumour showed that it harboured KRAS c.182A > T (p.Gln61Leu) mutation, which was similar to the mutation reported on the primary lung adenocarcinoma. Based on this he received adjuvant chemotherapy and immunotherapy (carboplatin, pemetrexed and pembrolizumab) and a CT scan performed two months after the small bowel resection demonstrated no evidence of tumour recurrence. He, however, developed chemotherapy-related nausea and vomiting, and with further deterioration was placed on a palliative care pathway and died 3 months after the bowel resection. This case highlights the role of integrating histopathology, immunohistochemistry, and molecular genetics in distinguishing metastatic from primary small intestinal adenocarcinomas.

Source: Oxford Medical Case Reports

DOI: 10.1093/omcr/omaf308

Authors: Sayed A Almahari, Abed M Zaitoun, Mina Fouad, Dileep N Lobo

Institutions: Nottingham University Hospitals NHS Trust, Queen's Medical Centre, University of Nottingham, Nottingham Biomedical Research Centre, University of Pennsylvania

Language: English

Topic: Metastasis and carcinoma case studies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,103