[Tryptic pancreatitis in small-cell bronchial carcinoma (author's transl)]

In two cases of typical small-cell bronchial carcinoma (one of them peripheral, small and clinically not diagnosed) destructive parenchylmal metastases in the pancreas, carcinomatous lymphoangiosis and infiltration of the larger excretory ducts by tumour cells were demonstrated. In both the clinical course was dominated by tryptic pancreatitis with treatment-refractory hypokalaemia. Since pancreatic metastases occur in about 10% of bronchial carcinomas, tryptic pancreatitis is, however, only rarely observed. It is, therefore, likely that autodigestion occurs only if in addition to parenchymal destruction by the metastases there are other factors. These may be blockage of lymphatic flow by carcinomatous lymphangiosis and duct stenosis by tumour infiltration of the walls. Hypercorticism due to ectopic ACTH production by the small-cell carcinoma may also be factor, but is without proof.