Obstructive jaundice in small cell lung carcinoma
- Author:
Ali Mokhtar Pour
;
Noraidah Masir
;
D.Phil
;
Isa Mohd Rose
- Publication Type:Case Reports
- Keywords:
small cell carcinoma;
lung;
obstructive jaundice;
metastasis;
pancreas
- From:The Malaysian Journal of Pathology
2015;37(2):149-152
- CountryMalaysia
- Language:English
-
Abstract:
Small cell lung carcinoma (SCLC) commonly metastasizes to distant organs. However, metastasis to the
pancreas is not a common event. Moreover, obstructive jaundice as a first clinical presentation of SCLC
is extremely unusual. This case reports a 51-year-old male with SCLC, manifesting with obstructive
jaundice as the initial clinical presentation. Endoscopic retrograde cholangiopancreatograghy (ERCP)
and abdominal computed tomography (CT) scan showed a mass at the head of the pancreas. The patient
underwent pancreatoduodenectomy (Whipple procedure). Histopathology revealed a chromogranin-
A-positive poorly-differentiated neuroendocrine carcinoma of the pancreas. No imaging study of
the lung was performed before surgery. A few months later, a follow-up CT revealed unilateral lung
nodules with ipsilateral hilar nodes. A lung biopsy was done and histopathology reported a TTF-
1-positive, chromogranin A-positive, small cell carcinoma of the lung. On review, the pancreatic
tumour was also TTF-1-positive. He was then treated with combination chemotherapy (cisplatin,
etoposide). These findings highlight that presentation of a mass at the head of pancreas could be a
manifestation of a metastatic tumour from elsewhere such as the lung, and thorough investigations
should be performed before metastases can be ruled out.
- Full text:P020150923612504453392.pdf
