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METASTATIC LUNG CARCINOMA TO THE ANUS DESPITE RADIATION THERAPY FOR SQUAMOUS CELL CARCINOMA
M Sunderland, M Read, RD Bennett
University of South Florida

Background
Lung cancer remains the leading cause of cancer related deaths worldwide. It frequently progresses to metastatic disease, associated with very poor overall survival. Metastatic spread to the anus and perianal region, however, is an extremely rare phenomenon. We present a case of a 69-year-old male, with multiple synchronous primary malignancies, who was found to have primary lung adenocarcinoma metastasis to the anus, despite radiation therapy for primary squamous cell carcinoma of the anus.

Methods
We used online search engines including Pubmed, Cochrane, and Embase to review available published medical literature. We reviewed cases of primary lung cancer spread to the anus, as well as metastasis after chemoradiation for treatment of anal squamous malignancy.

Results
There are thirteen reports of lung cancer metastasis to the anus. We did not find any reports of lung cancer spread to radiation sites after treatment for anal squamous cancer. Unfortunately, the reported survival in these patients was poor, all deaths occurring in less than one year. The majority were treated with chemoradiation as surgical resection for cure is not possible.

Conclusion
This is the first report, to our knowledge, of metastatic lung adenocarcinoma to the anus after prior chemoradiation therapy for anal squamous carcinoma. This is now one of fourteen cases of metastatic lung cancer spread to the anus. He is being treated with chemotherapy and is currently recovering at home. His response to therapy and survival will be closely followed.


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