International Scholarly Research Network ISRN Gastroenterology Volume 2011, Article ID 137139, 4 pages doi:10.5402/2011/137139 Case Report Colonic Metastases from Pleomorphic Carcinoma of the Lung Presenting as an Ileocecal Intussusception Sadat Rashid, 1 Dhyan Rajan, 2 Robin Jacob, 2 Keith Dahl, 1 Apsara Prasad, 1 Jaspreet Singh, 1 Ghulam Siddiqui, 1 Venkatesh Sasthakonar, 3 Lester Freedman, 4 Wondwoosen Gebre, 4 Umeko Takeshige, 1 Krishnaiyer Subramani, 1 Kaleem Rizvon, 1 and Paul Mustacchia 1 1 Department of Gastroenterology, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA 2 Department of Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA 3 Department of Surgery, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA 4 Department of Pathology, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, USA Correspondence should be addressed to Sadat Rashid, srashid@numc.edu Received 21 March 2011; Accepted 9 April 2011 Academic Editors: L. Bonavina, C. H. Cho, and T. Joh Copyright © 2011 Sadat Rashid et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pleomorphic carcinoma is a rare aggressive type of lung cancer that uncommonly metastasizes to the bowel, leading to bleeding, perforation, obstruction, and rarely intussusception. Serving as a lead point, metastatic lesions in the bowel may precipitate intussusception and require immediate surgical intervention. We present a rare case of colonic metastases from a primary lung malignancy, causing ileocecal intussusception in a 57-year old male. 1. Introduction Pleomorphic carcinoma of the lung is rare and accounts for less than 1% of all lung malignancies. Metastasis to the bowel from a primary lung malignancy is a rather uncommon finding and often remains clinically silent. Rarely reported, bowel metastasis may lead to intestinal intussusception, which requires prompt surgical intervention. We describe a case of ileocecal intussusception secondary to metastatic pleomorphic carcinoma of the lung. 2. Case Report A 57-year-old African American male presented to the medical emergency room with complaints of progressively worsening dyspnea for 1 month, productive cough for 2 weeks, and hemoptysis for the past 3 days. Review of symp- toms was significant for night sweats and an unintentional weight loss of 30 pounds in the last three months. Past medical history included hypertension, dyslipidemia, and 35 pack-years of cigarette smoking. Physical examination was significant for marked pallor, a body mass index (BMI) of 17 kg/m 2 , and decreased breath sounds over the left lung base on chest auscultation. Laboratory studies revealed a hemoglobin of 4.2 g/dL, hematocrit of 13.2%, white blood cell count of 9,100/mm 3 , and a platelet count of 214,000/mm 3 . Fecal occult blood testing was positive, and there was evidence of iron deficiency anemia. Chest radiography showed an infiltrate in the left middle and lower lung fields. Subsequent computed tomography (CT) of the chest showed the presence of a 1.9 × 1.6 cm spic- ulated mass in the right upper lobe suspicious for a neoplasm (Figure 1(a)), with consolidation involving the left lower lobe. The patient underwent bronchoscopy that did not reveal any endobronchial lesions, and bronchoalveolar lavage and bronchial brushings were negative for any malignant cells. Subsequent CT-guided biopsy of the lung mass was pos- itive for non-small cell lung carcinoma (NSCLC). During the hospital stay, the patient complained of se- vere abdominal pain, abdominal distension, and nausea. A CT scan of the abdomen revealed cecal colitis with