A Case of Extensive Stage Small Cell Lung Cancer Presenting as an Acute Appendicitis with Perforation

전이성 병소에 의해 발생한 급성 충수염의 천공으로 진단된 전신병기 소세포폐암 1예

  • Shin, Dong Won (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Choi, Moon Han (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Park, Seung Sik (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Park, Sung Woo (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Kim, Ki Up (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Jang, An Soo (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Park, Choon-Sik (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Lim, Cheol Wan (Department of Surgery, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Ko, Eun Suk (Department of Pathology, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Paik, Sang Hyun (Department of Radiology, Bucheon Hospital, Soonchunhyang University School of Medicine) ;
  • Kim, Do Jin (Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University School of Medicine)
  • 신동원 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 최문한 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 박승식 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 박성우 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 김기업 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 장안수 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 박춘식 (순천향대학교 의과대학 부천병원 내과학교실) ;
  • 임철완 (순천향대학교 의과대학 부천병원 외과학교실) ;
  • 고은석 (순천향대학교 의과대학 부천병원 병리학교실) ;
  • 백상현 (순천향대학교 의과대학 부천병원 영상의학교실) ;
  • 김도진 (순천향대학교 의과대학 부천병원 내과학교실)
  • Received : 2008.08.25
  • Accepted : 2008.09.09
  • Published : 2008.09.30

Abstract

The incidence of appendiceal metastatic cancer is quite low. In particular, in small cell lung cancer, there is a very low incidence of a metastasis to the appendix. A 75-years old man with right lower quadrant pain, cough and sputum was transferred to our hospital. Abdominal CT revealed acute appendicitis with a perforation. The patient underwent surgery. The frozen sections of the tissue obtained during surgery, indicated a malignancy, but a right hemicolectomy was not performed due to the patient's poor general condition. The histology findings of the appendix were identified as a small cell carcinoma. The abdominal CT scan and chest x-ray at admission day showed a mass in the right lower lobe, and a further evaluation of the lesion was performed including positron emission tomography and flexible bronchoscopy with a biopsy. The pathology findings of the lung mass were also small cell lung cancer. The specimens from both sites stained positive for cytokeratin, cluster designation 56, synaptophysin, chromogranin-A and thyroid transcription factor 1. It was concluded that the appendiceal small cell cancer originated from the lung.

본 증례에서 환자는 폐렴 치료 중 갑자기 발생한 복통을 주소로 급성 충수염을 진단받고 수술을 시행 받았다. 그 후 조직 검사 결과 소세포암으로 진단되었고 폐병변에 대해 추가적인 검사 결과 소세포폐암이 진단된 경우이다. 저자들은 소세포폐암의 충수 전이를 국내에서 처음으로 경험하여 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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