What happened, in summary

A 51-year-old man went to the hospital with severe abdominal pain, bloating, and vomiting after several months of milder abdominal symptoms and declining health. Imaging showed a 5 cm mass blocking the small bowel, and he needed emergency surgery to remove the affected section.

Pathology showed that the bowel tumor was metastatic adenocarcinoma from the lung. A chest CT performed after surgery then found a right lung mass and enlarged chest lymph nodes. He had not experienced respiratory symptoms before the bowel obstruction. Because the lung cancer had already spread to the small bowel, the disease was Stage IV at diagnosis.

He began chemotherapy after recovering from surgery. After 3 courses, however, his condition deteriorated and treatment was stopped. He developed headaches and back pain, and follow-up scans showed further progression to the brain and spine.

He was then admitted to palliative care. The case shows how lung cancer can occasionally first appear through symptoms caused by spread outside the chest, rather than through cough or breathing problems.