Obstructive jaundice due to pancreatic metastasis from non-small cell lung cancer

We report a 67-year-old female patient, recently diagnosed to have non-small cell lung cancer (NSCLC). On first PET (positron emission tomography) examination in October 2009, no distant metastasis. Four months later, second PET examination was done, detecting pancreatic foci in the uncinate process and in the tail of the pancreas measuring 22 mm which were more likely to be metastatic rather than primary origin. The patient underwent chemotherapy and radiotherapy. After 1 month of follow up, jaundice was noticed. Laboratory exams and MRCP showed obstructive jaundice. ERCP was performed with biliary stenting for palliative treatment. Symptomatic metastatic lesions of the pancreas from carcinoma of the lung are extremely rare. Typically, the patients remain asymptomatic until their disease reaches a fairly advanced stage, and therapeutic options are then limited to palliative measures.