Hyperamylasaemia and dual paraneoplastic syndromes in small cell lung cancer

Ann Clin Biochem. 2014 Jan;51(Pt 1):101-5. doi: 10.1177/0004563213500658. Epub 2013 Sep 18.

Abstract

We hereby describe the rare case of a 59-year-old patient presenting with marked hyperamylasaemia mimicking acute pancreatitis upon admission. Investigation of co-existent hypokalemia revealed the presence of ectopic adrenocorticotropic hormone secretion, leading to the final diagnosis of small cell lung cancer, exhibiting dual paraneoplastic syndromes including Cushing Syndrome and hyperamylasaemia. Although, paraneoplastic syndromes occur commonly, paraneoplastic hyperamylasaemia especially in the context of dual paraneoplastic syndromes occurring simultaneously, is extremely rare. Such misleading manifestations require a high index of suspicion on behalf of the physician, so that an underlying malignancy is not missed, and a final diagnosis combining all clinical and laboratory findings is reached. In turn, in rare cases common biochemical markers such as amylase can be used as a useful follow up index driving further management.

Keywords: Amylase; cancer; tumour markers.

Publication types

  • Case Reports

MeSH terms

  • Adrenocorticotropic Hormone / blood
  • Amylases / metabolism
  • Biomarkers, Tumor / metabolism
  • Cushing Syndrome / blood
  • Cushing Syndrome / pathology
  • Diagnosis, Differential
  • Humans
  • Hyperamylasemia / blood*
  • Male
  • Middle Aged
  • Pancreatitis / blood*
  • Pancreatitis / pathology
  • Paraneoplastic Syndromes / blood
  • Paraneoplastic Syndromes / pathology*
  • Small Cell Lung Carcinoma / blood*
  • Small Cell Lung Carcinoma / pathology

Substances

  • Biomarkers, Tumor
  • Adrenocorticotropic Hormone
  • Amylases