Acute pancreatitis secondary to small-cell lung cancer metastasis: A case report and literature review

Abstract

Background: Acute pancreatitis (AP) is commonly encountered in gastroenterology, with biliary and alcohol-related causes being predominant. Among less frequent etiologies, metabolic and drug-induced origin are the most prevalent. As an exception, non-pancreatobiliary malignancies may trigger AP, representing less than 1% of cases. We present a case of AP secondary to an uncommon oncologic etiology.

Case summary: We describe the case of a 50-year-old male recently diagnosed with small-cell lung cancer (SCLC). The patient was admitted to the emergency department with acute abdominal pain and subsequently diagnosed with AP. He was hospitalized under the care of the gastroenterology service. During the etiological workup, metastatic pancreatic lesions were identified on imaging, which had not been observed on the initial cancer staging. Following resolution of the initial episode, oral intake was introduced, but the patient experienced recurrent abdominal pain and laboratory abnormalities consistent with new episodes of AP. This pattern repeated over the following days. After several episodes, and with suspicion of a metastatic origin, the case was discussed in multidisciplinary meeting. In agreement with the patient and given the need to initiate treatment for the primary tumor as well, chemotherapy was started. This treatment successfully alleviated symptoms, allowing dietary progression without complications and discharge from the hospital.

Conclusion: Oncologic treatment can be considered as part of the therapeutic approach in AP secondary to SCLC metastasis, especially chemotherapy.

Keywords: Acute pancreatitis; Case report; Chemotherapy; Metastasis; Small-cell lung cancer.