A 69-year-old male, former smoker, with an infrarenal abdominal aortic aneurysm 7.5 cm and anticoagulation for previous pulmonary thromboembolism, was diagnosed with non-small cell lung carcinoma NSCLC upper lobe T3aN2.
Considered unresectable, he underwent 4 cycles of cisplatin-vinorelbin along with thoracic radiotherapy, with moderate response.
Six months after diagnosis, the patient was admitted for diffuse abdominal pain of six days onset and sporadic vomiting.
The patient had mild hypoalbuminemia and anemia of 6.5 g/dl -requiring bladder concentrates-.
Abdominal-pelvic CT scan reported a mass originating from the mesentery encompassing several loops of the intestine.
Ultrasonography showed a fistulous tract between the loops of the small intestine and a phlegmonous area with small bubbles of extraoral gas, so antibiotic treatment was instituted.
On the 5th day she developed an obstructive condition and was operated on urgently.
An abdominal mass of 15 cm in diameter was found in the mesentery at the level of the promony and aneurysm.
This included the small intestine, two deerical loops, a ileocolonial loop -a 30 cm from the cecal valve - and the sigmoid colon - a 10 cm long segmental anastomosis.
Pathological examination revealed the presence of facial expressions of fat mass and extension towards the wall of the intestinal loops, reaching the mucosa, encompassing areas of anatomy formation and consolidation.
The postoperative period was uneventful -recovered oral intake and intestinal transit - until the 8th day, when there was a fever peak.
CT scan showed a collection of 8 cm, because of the minimal manifestation of sigma, which was drained and resolved radiologically.
She was discharged with normal intestinal function.
In the following weeks, she experienced rapid deterioration of her general condition and progression of the tumor disease (pulmonary carcinomatous lymphangitis, growth of subcutaneous metastasis to the chest wall, tumour hypercalcaemia).
Not being able to start a second line of chemotherapy, he died a month and a half after surgical removal of abdominal metastases.
