Colon Metastasis From Primary Lung Cancer - A Report of a Rare Case and Review of Diagnostic and Therapeutic Challenges

Sep 29, 2026

This case report describes colon metastasis originating from primary lung adenocarcinoma and details the diagnostic and therapeutic complexities. A 62-year-old woman with biphenotypic lung carcinoma developed gastrointestinal symptoms; imaging and endoscopy identified a 3 cm sessile polypoid ascending-colon lesion. Histopathology and immunohistochemistry confirmed metastatic adenocarcinoma from the lung primary. Endoscopic mucosectomy achieved clear margins, followed by targeted therapy with osimertinib after an EGFR mutation. The report emphasizes considering lung cancer metastasis in colonic differential diagnoses and using multidisciplinary management for rare presentations.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Case Presentation

Thoracic imaging and initial lung diagnosis

Treatment course and molecular profiling

Progression and recurrence

Presentation with gastrointestinal symptoms

Review began 10/31/2025 Review ended 11/27/2025 Published 12/07/2025 © Copyright 2025 Averbach et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98650 Open Access Case Report Colon Metastasis From Primary Lung Cancer: AReport of a Rare Case and Review of Diagnostic and Therapeutic Challenges Pedro Averbach 1, Caroline Cirenza 1, Pedro Popoutchi 1, Marcelo Averbach 1 1. Department of Gastroenterology, Hospital Sírio-Libanês, Sao Paulo, BRA Corresponding author: Caroline Cirenza, [carolcirenza@gmail.com](carolcirenza@gmail.com) Abstract This case report aims to describe the rare occurrence of colon metastasis that originated from primary lung adenocarcinoma, highlighting the diagnostic challenges, therapeutic interventions, and clinical implications. A 62-year-old woman diagnosed with a biphenotypic lung carcinoma (squamous andadenocarcinomatous components) developed gastrointestinal (GI) symptoms. Imaging and endoscopic evaluation revealed a 3 cm sessile polypoid lesion in the ascending colon. Histopathological analysis and immunohistochemical profiling confirmed the lesion as a metastatic adenocarcinoma from the primary lung cancer. The patient underwent successful endoscopic mucosectomy with clear surgical margins, followed by targeted therapy with osimertinib due to the presence of an epidermal growth factor receptor (EGFR) mutation. Thus, this case underscores the necessity of considering metastatic lung cancer in the differential diagnosis of colonic lesions, particularly in patients with a known history of lung cancer. Comprehensive histopathological and immunohistochemical analyses are crucial for accurate diagnosis. The management of such rare metastases requires a multidisciplinary approach, integrating surgical and targeted therapies to improve patient outcomes. This report adds valuable insights into the clinical presentation, diagnostic processes, and therapeutic strategies for atypical metastatic patterns in lung cancer. Categories: Pathology, Oncology, Gastroenterology Keywords: colon metastasis, endoscopic mucosectomy diagnosis, gastrointestinal bleeding, gastrointestinal metastases, primary lung cancer Introduction Lung cancer, a leading cause of cancer-related mortality globally, is known for its aggressive nature and potential to metastasize to various organs [1] . However, gastrointestinal (GI) tract metastasis is uncommon, with an incidence of 0 .2%-1 . 7%[2-5]. Among the GI tract, the colon is even rarer, often leading to diagnostic challenges and therapeutic dilemmas [6,7] . This case report presents a unique instance of gastrointestinal bleeding caused by colon metastasis originating from primary lung cancer, contributing to the limited but growing literature on this atypical presentation. This detailed examination of the patient 's clinical journey, including diagnostic challenges and treatment outcomes, aims to shed light on this rare clinical entity. The case contributes to the existing literature on lung cancer metastases and underscores the importance of considering atypical metastatic sites in oncological diagnoses and management. Case Presentation A 62-year-old woman from São Paulo, Brazil, presented to the emergency department with acute hemoptysis in January 2021. She had a history of chronic disseminated intravascular coagulation and chronic autoimmune hepatopathy managed with prednisone. She also reported significant tobacco use (40 pack-years) . A computed tomography (CT) of the thorax was taken and revealed a 6.3 cm partially cavitated mass in the basal segment of the lower right lobe, abutting the pleura, accompanied by a proximal 2 cm nodule (Figure 1) . A biopsy performed on February 1, 2022, on the right lung lesion, identified

FAQs

What condition does the report focus on?

The report focuses on colon metastasis that originated from primary lung adenocarcinoma, presenting as a rare gastrointestinal manifestation.

How was the colon lesion diagnosed as a metastatic lung cancer?

A 3 cm sessile polypoid ascending-colon lesion was evaluated using imaging and endoscopic assessment, then confirmed as metastatic adenocarcinoma from the lung primary through histopathological and immunohistochemical analysis.

What treatment did the patient receive after confirmation of metastasis?

The patient underwent successful endoscopic mucosectomy with clear margins, and then received targeted therapy with osimertinib due to an EGFR mutation.

Sep 29, 2026

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