{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:43:17Z","timestamp":1787697797238,"version":"build-2784847793"},"reference-count":17,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,11,3]]},"abstract":"<jats:p>Metastasis to the tongue, duodenum or pancreas from primary lung cancer is uncommon. Primary lung cancer presenting with symptoms related to metastases at these sites, at initial presentation is extremely rare. We report a 45-year-old man with disseminated lung malignancy who presented with dyspepsia, melena, symptoms due to anaemia and swelling in the tongue. Oral examination revealed a hard submucosal anterior tongue lesion. Biopsies from the tongue lesion and the duodenal ulcer seen on upper gastrointestinal endoscopy were suggestive of metastasis from lung primary. CT revealed lung primary with disseminated metastasis to lung, liver, adrenals, kidneys, head and body of pancreas, duodenum and intra-abdominal lymph nodes. The patient was treated with palliative chemotherapy. The unusual presentation and diagnostic details are discussed.<\/jats:p>","DOI":"10.1136\/bcr-2016-217539","type":"journal-article","created":{"date-parts":[[2016,11,18]],"date-time":"2016-11-18T08:30:17Z","timestamp":1479457817000},"page":"bcr2016217539","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Oral and gastrointestinal symptomatic metastases as initial presentation of lung cancer"],"prefix":"10.1136","volume":"2016","author":[{"given":"Jenifer","family":"Jeba","sequence":"first","affiliation":[{"name":"Palliative Care Unit, Christian Medical College Hospital, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvamani","family":"Backianathan","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Christian Medical College Hospital, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunadala","family":"Ishitha","sequence":"additional","affiliation":[{"name":"Department of General Pathology, Christian Medical College and Hospital Vellore, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Christian Medical College and Hospital, Vellore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,11,18]]},"reference":[{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70188-9"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.suronc.2014.02.004","article-title":"Prevalence, clinicopathological characteristics, treatment, and prognosis of intestinal metastasis of primary lung cancer: a comprehensive review","volume":"23","author":"Di","year":"2014","journal-title":"Surg Oncol"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.3","first-page":"771","article-title":"Upper gastrointestinal bleeding due to superior mesenteric artery to duodenum fistula: a rare complication of metastatic lung carcinoma","volume":"86","author":"Steinhart","year":"1991","journal-title":"Am J Gastroenterol"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.4","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1007\/BF02482332","article-title":"Duodenal metastasis from large cell carcinoma of the lung: report of a case","volume":"29","author":"Hinoshita","year":"1999","journal-title":"Surg Today"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.5","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1055\/s-2007-1009092","article-title":"Duodenal metastases from lung cancer","volume":"26","author":"Raijman","year":"1994","journal-title":"Endoscopy"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.6","first-page":"185","article-title":"Duodenal metastases from squamous cell carcinoma of the lung: endoscopic management of bleeding and biliary and duodenal obstruction","volume":"23","author":"Misra","year":"2004","journal-title":"Indian J Gastroenterol"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.7","first-page":"2881","article-title":"Patterns of pancreatic metastasis from lung cancer","volume":"18","author":"Maeno","year":"1998","journal-title":"Anticancer Res"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.8","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-004-1100-7"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.9","first-page":"61","article-title":"Metastatic non-small-cell lung cancer to the liver and pancreas","volume":"7","author":"Matt","year":"2014","journal-title":"Gastrointest Cancer Res"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.10","doi-asserted-by":"crossref","first-page":"132","DOI":"10.3904\/kjim.2006.21.2.132","article-title":"Pancreatic metastasis and obstructive jaundice in small cell lung carcinoma","volume":"21","author":"Jeong","year":"2006","journal-title":"Korean J Intern Med"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.11","first-page":"698","article-title":"A resected case of solitary pancreatic metastasis from adenocarcinoma of the lung","volume":"9","author":"Mori","year":"2008","journal-title":"JOP"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.12","doi-asserted-by":"crossref","first-page":"727","DOI":"10.2169\/internalmedicine.43.727","article-title":"Tongue metastasis as an initial presentation of a lung cancer","volume":"43","author":"Terashima","year":"2004","journal-title":"Intern Med"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.13","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1177\/000313480507100204","article-title":"A case and review of bowel perforation secondary to metastatic lung cancer","volume":"71","author":"Garwood","year":"2005","journal-title":"Am Surg"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.14","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/030089160609200218","article-title":"Abdominal metastases from lung cancer resulting in small bowel perforation: report of three cases","volume":"92","author":"Savanis","year":"2006","journal-title":"Tumori"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.15","first-page":"109","article-title":"Iron deficiency anemia as initial presentation of a non-small cell lung carcinoma: A case report","volume":"16","author":"Linsen","year":"2015","journal-title":"Respir Med Case Rep"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0169-5002(99)00075-6"},{"key":"2025082804090232000_2016.nov18_1.bcr2016217539.17","doi-asserted-by":"crossref","first-page":"e1004571","DOI":"10.1371\/journal.pcbi.1004571","article-title":"Mathematical modelling of molecular pathways enabling tumour cell invasion and migration","volume":"11","author":"Cohen","year":"2015","journal-title":"PLoS Comput Biol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-217539","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:09:12Z","timestamp":1756379352000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-217539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,18]]},"references-count":17,"alternative-id":["10.1136\/bcr-2016-217539"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-217539","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,18]]}}}