Case Report Small Cell Lung Cancer Combined with Acute Pancreatitis

A 64-year-old man who developed persistent hemoptysis for 2 months. Chest CT scan with contrast enhancement showed an irregular lesion, about 4.0 x 1.5 x 1.2 cm in size over right lower lobe with pleural thickening, mediastinal lymphadenopathy, adrenal gland and bone me-tastasis. The pathology of bronchoscopic tissue biopsy showed small cell lung cancer. During hospitalization, he complained of epigastralgia with radiation to the back. The blood test showed elevated amylase and lipase levels. The magnetic resonance imaging (MRI) revealed swollen pancreas but no choledocholithiasis. Acute pancreatitis was diagnosed. Pancreatitis re-lapsed again after conservative treatment. After reviewing the previous imaging study, a low-density lesion in the pancreas was found. Metastasis induced acute pancreatitis (MIAP) was suspected. We gave him systemic chemotherapy with the regimen of etoposide and cis-platin. Abdominal pain subsided quickly and the serum level of amylase and lipase returned to normal range later. During the regular follow-up in the outpatient clinics, he did not experience the same episode again. In the literature, the majority of MIAP is caused by small cell lung cancer. Poor prognosis was noted, especially in patients with high Ranson’s scores. In patients with small cell lung cancer who develop epigastralgia and elevated level of lipase and amylase