CTICasesSquamous Cell Carcinoma of the Lung with Small Bowel Perforation
Imaging findings
The PA radiograph shows right paratracheal stripe thickening, fullness in the upper mediastinum, and a mass-like area in the left lower lobe. The lateral view confirms a well-circumscribed mass. CT reveals extensive, confluent mediastinal lymphadenopathy (narrowing the SVC) and a left hilar mass. Abdominal imaging shows necrotic mesenteric lymph nodes, small bowel wall thickening, extraluminal gas indicating a small bowel perforation, and a lytic lesion in the iliac crest.
Key takeaways
Advanced squamous cell carcinoma of the lung can present with extensive mediastinal and hilar lymphadenopathy, direct lung masses, and distant metastases. This case uniquely highlights presentation with small bowel perforation due to tumor infiltration of the bowel wall, demonstrating the varied and aggressive nature of metastatic lung cancer. A comprehensive CT scan from chest to pelvis is essential for identifying all manifestations of widespread malignancy.
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