Carcinoma of the lung with marked hyperamylasemia and elevated serum calcitonin

Ectopic production of multiple peptide hormones is a frequent concomitant of neoplasia. An elderly man with metastatic small cell carcinoma of the lung presented with back pain, a right hilar mass, and was demonstrated to have markedly elevated serum calcitonin and amylase levels. Polyacrylamide gel electrophoresis revealed a striking elevation of a "salivary type" isoamylase. We report this case as an unusual association of production of both a peptide hormone and a nonhormonal peptide in a patient with a tumor of "neural crest" origin.