A case of small cell carcinoma of the lung diagnosed initially as acute pancreatitis

Abstract

Although tumor metastases to the pancreas are often found in case of small cell carcinoma of the lung, acute pancreatitis induced by metastasis is a rare initial manifestation. A 52–year–old man was diagnosed as acute pancreatitis because of his back pain in November 2004. Abdominal CT scan showed a pancreatic head tumor with paraaortic lymph nodes metastases. He was diagnosed as having unresectable pancreatic cancer. Although chemotherapy was started after recovering from pancreatitis, he suffered from pneumonitis and chemotherapy was stopped at the first week. He visited our hospital for the further treatment of his pancreatic tumor at the end of December 2004. At admission, his neck lymph nodes were swollen and he was suffring from superior vena cava syndrome. Biopy of the lymph nodes revealed a metastasis of small cell carcinoma of the lung. Finally, he was diagnosed as having small cell lung cancer with multiple metastases including pancreas. He underwent chemotherapy with Cisplatin (60mg/m²) and Irinotecan (60mg/m²) and radiation therapy to the neck region. Although these treatments were effective for more than 6 months, he died 11 months after the initial admission. In conclusion, we experienced a patient with small cell carcinoma of the lung who was initially diagnosed as pancreatic cancer.