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Lung carcinosarcoma is a neoplasm of high grade composed of epithelial and mesenchymal cells. It is exceptional; and usually affects men who are smokers, between the fifth and eighth decades of life. Medical treatment, chemotherapy and radiotherapy are not active in this kind of tumour, so surgery is the treatment of choice. Prognosis is poor with survival rates at 6 months around 27%. We describe the diagnostic process and the clinical outcome of a patient with lung carcinosarcoma with several paraneoplastic syndromes.

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e20727 Background: Nausea, vomiting, and diarrhea are very common in cancer patients under palliative treatment. These usually can be controlled on an outpatient basis, although they can become extremely debilitating for the patient. It is not uncommon that patients come to the emergency department because of the rebelliousness of these symptoms. The aim of this study is to describe cancer patient population which consults for nausea, vomiting, or diarrhea in the Emergency Department (ED) of a tertiary hospital, their causes and clinical management. Methods: From October 2007 to October 2008, all cancer patients attended at the Emergency Department of our hospital were prospectively collected. The reasons for consultation, diagnosis and clinical management in the SE are described Results: Of 560 patients enrolled, 440 patients were stage IV disease. 54.8% of them ( 307 patients) were under palliative chemotherapy treatment at the time of consultation. 5.9% consulted for nausea or vomiting (33 patients), 3.6% (20 patients) consulted for diarrhea, 0.7% (4 patients) consulted for both. 57.5% of patients (19 patients) with nausea or vomiting, 90% (18 patients) with diarrhea and 100% (4 patients) with both symptoms were receiving chemotherapy at that moment. The most frequent causes of these symptoms were chemotherapy toxicity (52.6%) and acute abdominal pathology (15.8%). 24 patients (72.7%%) who consulted for nausea or vomiting, 12 patients (60%) who consulted for diarrhea and 3 patients (75%) who consulted for vomiting and diarrhea required at least 24 hours of hospitalization. Conclusions: Vomiting and diarrhea are very prevalent symptoms in oncology patients, but they are not frequent causes of demanding emergency attention. The most important etiology of these situations is the chemotherapy toxicity, followed by acute abdominal pathology. Most patients attended in ED because of these symptoms require hospitalization. No significant financial relationships to disclose.