Acute Pancreatitis: First and Sole Manifestation of Small Cell Carcinoma of Lung

Abstract

Small cell carcinoma of the lung is an aggressive disease that tends to metastasize early in its course and has a poor prognosis. Pancreatic metastasis generally constitutes a late manifestation of this disease and most patients do not have organ specific symptoms (jaundice, abdominal pain and weight loss), and it is incidentally discovered on imaging studies. However, acute pancreatitis as the initial presentation of small cell carcinoma of lung is extremely rare. We came across a 71-year-old female who was admitted to the hospital for abdominal pain secondary to acute pancreatitis. Further workup revealed metastatic small cell carcinoma of lung. In English literature we found 11 other cases of small cell carcinoma of lung which had acute pancreatitis as their sole presentation. Therefore, it should be kept in mind as a very rare cause of acute pancreatitis in the right setting.

Metastasis-Induced Acute Pancreatitis Successfully Treated with Chemotherapy and Radiotherapy in a Patient with Small Cell Lung Cancer

“…In a study by Stewart et al that included the highest number of patients, only one patient was diagnosed with MIAP among 802 patients with lung cancer [ 10 ]. Although it is usually a late manifestation and present with extensive metastatic disease, it may rarely manifest as the initial symptom of the disease or as an isolated metastatic involvement [ 11 ].…”

“…Other possible causes associated with development of acute pancreatitis in patients with SCLC include alcohol intake, cholelithiasis, hypercalcemia, and the use of chemotherapy agents such as cisplatin, ifosfamide, and vinorelbine. In cases where no etiological factor exists, paraneoplastic acute pancreatitis may be developed [ 6 , 11 ].…”

Metastatic Small Cell Carcinoma Presenting as Acute Pancreatitis

“…Approximately 3% to 10.6% of all malignant tumors affect the pancreas [1]. The lung is the most common primary site for metastatic pancreatic tumors [2]. SCLC is the most common lung malignancy to invade pancreatic tissue, and postmortem autopsies of SCLC patients show metastases to the pancreas in up to 40% of cases [1][2][3][4][5].…”

“…The lung is the most common primary site for metastatic pancreatic tumors [2]. SCLC is the most common lung malignancy to invade pancreatic tissue, and postmortem autopsies of SCLC patients show metastases to the pancreas in up to 40% of cases [1][2][3][4][5]. Metastatic SCLC presents in three significant forms in the pancreas: as a well-circumcised lesion (50%-73%), generalized pancreatic enlargement (15%-44%), and as multiple small nodules (5%-10%) [5].…”