METASTASIS-INDUCED ACUTE-PANCREATITIS AS THE INITIAL MANIFESTATION OFBRONCHOGENIC-CARCINOMA

Metastasis-induced acute pancreatitis (MIAP) is a very rare initial ma nifestation of lung cancer. A review of one institution's experience a nd the English language medical literature was conducted to define the incidence, natural history, and optimal treatment of this unusual cli nical problem. One of 802 (0.12 percent) lung cancer patients presente d with MIAP. Seven additional cases were found in the literature. Smal l-cell carcinoma was present in six of eight patients. Prognosis is po or. Four patients died within two weeks of hospital admission. In pati ents with small-cell carcinoma and mild pancreatitis, chemotherapy may favorably influence recovery from pancreatitis. Those with severe pan creatitis tolerate chemotherapy poorly and initial supportive manageme nt is advisable. Patients with small-cell histologic features who reco ver from pancreatitis should receive chemotherapy. Survival beyond six months is possible.