Usefulness of a Colonic Stent for Colonic Obstruction Caused by Lung Cancer Metastasis

The gastrointestinal tract is not a common site for metastasis from lung cancer, and colonic metastases are especially rare. Although surgical intervention can improve colonic obstruction, perioperative mortality is high in patients with advanced malignancy, and these patients experience a significant deterioration in quality of life postoperatively. This report describes an uncommon case of colonic metastasis from non-small cell lung cancer (NSCLC), in which colonic obstruction was improved with a selfexpanding metallic stent. A 62-year-old man was admitted to our hospital for progressively worsening abdominal pain. He had been treated with immunotherapy and chemotherapy after being diagnosed with NSCLC (T4N2M1) 1.5 years earlier. Enhanced computed tomography showed intestinal obstruction and a mass in the colon at the hepatic flexure. Histopathological analysis of a biopsy specimen confirmed NSCLC metastasis. Considering his general condition, endoscopic stenting was chosen as an urgent decompression procedure. He was discharged 45 days after stenting and was able to resume immunotherapy. Emergency stenting could be offered at experienced centers when operative intervention is not part of the treatment plan, as it is safe and improves the efficiency of care along with the quality of life. (J Nippon Med Sch 2021; 88: 556―560).