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Obstructive jaundice in small cell lung carcinoma.

Ali Mokhtar Pour¹, Noraidah Masir, Mohd Rose Isa

¹UKM Medical Center, Faculty of Medicine, Department of Pathology, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia. noraidah@ppukm.ukm.edu.my.

The Malaysian Journal of Pathology

|August 17, 2015

Summary

This case highlights a rare instance of small cell lung carcinoma (SCLC) initially presenting as a pancreatic mass causing obstructive jaundice. Further investigation confirmed SCLC metastasis to the pancreas.

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Area of Science:

Oncology
Gastroenterology
Pathology

Background:

Small cell lung carcinoma (SCLC) frequently metastasizes, but pancreatic involvement is uncommon.
Obstructive jaundice as the initial presentation of SCLC is extremely rare.

Observation:

A 51-year-old male presented with obstructive jaundice.
Imaging revealed a pancreatic head mass; initial histopathology suggested pancreatic neuroendocrine carcinoma.
Post-operative imaging identified lung nodules, leading to a lung biopsy.

Findings:

The pancreatic tumor was confirmed as TTF-1-positive, chromogranin A-positive small cell carcinoma, consistent with metastatic SCLC.
The lung biopsy confirmed primary SCLC.
This indicates the pancreatic mass was a metastasis from SCLC.

Implications:

Pancreatic masses, especially those presenting with obstructive jaundice, should be investigated for potential metastatic disease from occult primary tumors like SCLC.
Thorough diagnostic workup is crucial to avoid misdiagnosis and ensure appropriate treatment for metastatic SCLC.