Pancreatic metastases are found in up to 40% of patients with small cell lung cancer, but metastasis-induced acute pancreatitis is rare. Treatment of metastasis-induced acute pancreatitis is initially supportive, but failure of conservative management are common. There are few reports on aggressive treatment with chemotherapy which lead to rapid clinical improvement and prolongation of survival in patients with metastasis-induced acute pancreatitis. We experienced a case of metastasis-induced acute pancreatitis in a patient with small cell lung cancer. Despite conservative treatment with dietary restriction and intravenous fluid supply, serum amylase levels increased persistently with severe abdominal pain. After chemotherapy with irinotecan and carboplatin, abdominal pain and serum amylase levels resolved dramatically.
Acute Disease ; Aged ; Carcinoma, Small Cell/*secondary ; English Abstract ; Humans ; Lung Neoplasms/*pathology ; Male ; Pancreatic Neoplasms/complications/*secondary ; Pancreatitis/*etiology

Primary lung cancer frequently metastasizes to distant organs. The pancreas is a relatively infrequent site of metastasis. Furthermore, obstructive jaundice resulting from pancreatic metastasis is extremely rare. This paper examines the case of a 65-year-old woman with small cell lung cancer initially presenting with extrahepatic biliary obstruction. The patient underwent percutaneous transhepatic biliary drainage. The obstruction was relieved with a stent placement, then the woman was treated with combination chemotherapy (irinotecan, cisplatin) and a complete remission achieved in six months.
Stents ; Pancreatic Neoplasms/*secondary ; Lung Neoplasms/complications/*pathology ; Jaundice, Obstructive/*etiologyherapy ; Humans ; Female ; Carcinoma, Small Cell/complications/*pathology ; Aged

Although liver metastasis is commonly found in cancer patients, fulminant hepatic failure secondary to diffuse cancer infiltration into the liver is rare. Liver metastasis-induced fulminant hepatic failure has been reported in patients with primary cancer of the gastrointestinal tract, breast and uroepithelium, and in patients with melanoma and hematologic malignancy. Small cell lung cancer is so highly invasive that hepatic metastasis is common, but rapid progression to fulminant hepatic failure is extremely rare. We report here on a case of a patient who died because of rapid progression to fulminant hepatic failure as a result of hepatic metastasis of small cell lung carcinoma.
Aged ; Carcinoma, Small Cell/complications/pathology/*secondary ; Female ; Humans ; Liver Failure, Acute/diagnosis/*etiology ; Liver Neoplasms/complications/pathology/*secondary ; Lung Neoplasms/complications/*pathology ; Neoplasm Invasiveness ; Tomography, X-Ray Computed

Lung cancer is the most commonly diagnosed cancer worldwide. Malignant pleural effusion (MPE) caused by advanced lung cancer seriously affect the patients' quality of life and prognosis. The management of MPE includes thoracentesis, pleurodesis, indwelling pleural catheters and drug perfusion in pleural cavity. Vascular endothelial growth factor (VEGF) and its receptor are a group of important ligands and receptors that affect angiogenesis. They are the main factors controlling angiogenesis, and they play an important role in the formation of MPE. Bevacizumab is a recombinant humanized VEGF monoclonal antibody, competitively binding to endogenous VEGF receptor. Bevacizumab can inhibit new blood vessel formation, reduce vascular permeability, prevent pleural effusion accumulation and slow the growth of cancers. This review aims to discuss the progress of bevacizumab in the treatment of MPE caused by non-small cell lung cancer (NSCLC), and explore the clinical application, efficacy, safety and future direction of bevacizumab.
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Antineoplastic Agents ; therapeutic use ; Antineoplastic Agents, Immunological ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; complications ; pathology ; Humans ; Pleural Effusion, Malignant ; drug therapy ; Pleural Neoplasms ; drug therapy ; secondary

Although gynecomastia is a well-defined paraneoplastic syndrome in patients with non-small cell lung cancer, the association with pleomorphic carcinoma has not been reported. A 50-yr-old man presented with bilateral gynecomastia and elevated serum beta-human chorionic gonadotropin (beta hCG) level. Chest tomography showed a mass in the right middle lobe. Right middle lobectomy and mediastinal lymph node dissection were performed. beta hCG levels decreased rapidly after surgery. Histological examination revealed pleomorphic carcinoma with positive immunostaining for beta hCG. Serum beta hCG levels began to increase gradually on postoperatively 4th month. Computed tomography detected recurrence and chemotherapy was started. After second cycle of chemotherapy, beta hCG levels decreased dramatically again and tomography showed regression in mass. Patient died 6 months later due to brain metastasis. beta hCG expression may be associated with aggressive clinical course and increased risk of recurrence, also beta hCG levels may be used to evaluate therapy response in patients with pleomorphic carcinoma.
Brain Neoplasms/radiotherapy/secondary ; Carcinoma, Non-Small-Cell Lung/complications/*diagnosis/pathology ; Chorionic Gonadotropin, beta Subunit, Human/*blood ; Gynecomastia/*etiology ; Humans ; Lung Neoplasms/complications/*diagnosis/pathology ; Lymph Nodes/surgery ; Male ; Middle Aged ; Recurrence ; Risk Factors ; Tomography, X-Ray Computed

Lung cancer metastases can occur in almost any organ. However, metastasis of small cell lung cancer to the pancreas is rare. Moreover, not all cases present with clinically diagnosed pancreatitis. We recently treated a patient with small cell lung carcinoma that invaded the pancreatic duct causing acute pancreatitis. Generally, the treatment for tumor-induced acute pancreatitis is initially supportive followed by aggressive chemotherapy or surgery. If the patient can tolerate the insertion of an endoscopic intrapancreatic stent, this is performed in addition to chemotherapy and surgery; this approach offers a safe and effective treatment modality for such patients.
Tomography, X-Ray Computed ; *Stents ; Prosthesis Implantation/*methods ; Pneumonectomy ; Pancreatitis/diagnosis/etiology/*surgery ; Pancreatic Neoplasms/*complications/secondary/therapy ; Pancreatic Ducts/radiography/*surgery/ultrasonography ; Middle Aged ; Lung Neoplasms/*pathology/therapy ; Humans ; Follow-Up Studies ; Female ; Endosonography ; Cholangiopancreatography, Endoscopic Retrograde ; Carcinoma, Small Cell/*complications/secondary/therapy ; Antineoplastic Agents/therapeutic use