Metastatic Extrapulmonary Small Cell Carcinoma Presenting as Obstructive Jaundice.

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Extrapulmonary small cell carcinoma (EPSCC) is rare, often diagnosed at advanced stages with widespread metastasis.
• Limited data exists for EPSCC, necessitating reliance on retrospective studies and expert opinions for management.
• This case highlights a unique presentation of EPSCC in an elderly male.

Observation:

• A 78-year-old male presented with abdominal pain, jaundice, and leukocytosis.
• Imaging revealed extensive liver metastases, suggestive of advanced malignancy.
• Endoscopic retrograde cholangiopancreatography showed normal biliary ducts, and a stent was placed for biliary drainage.

Findings:

• Liver biopsy confirmed poorly differentiated small cell carcinoma of extrapulmonary origin.
• Despite palliative interventions, the patient's condition deteriorated due to metastatic disease.
• The patient opted for comfort care and hospice, succumbing within days.

Implications:

• This case underscores the diagnostic difficulties and poor prognosis associated with EPSCC.
• It emphasizes the importance of considering EPSCC in elderly patients with unexplained obstructive jaundice and liver metastases.
• The report contributes to the limited literature on EPSCC, offering insights into its clinical presentation and management challenges.