Paraneoplastic lipase and amylase production in a patient with small-cell lung cancer: Case report

Andrea Casadei Gardini, Marita Mariotti, Alessandro Lucchesi, Sara Pini, Martina Valgiusti, Sara Bravaccini, Angelo Delmonte, Marco Angelo Burgio, Giorgia Marisi, Dino Amadori, Giovanni Luca Paolo Frassineti

Research output: Contribution to journalArticle

Abstract

Background: Small-cell lung cancer (SCLC) is known to express antigens of both the neural crest and epithelium, and to secrete polypeptide hormones and enzymes. Anecdotal reports correlate lung cancer with marked hyperamylasemia, and a review of the literature reveals only one case of metastatic SCLC linked to high paraneoplastic lipase production. Case presentation: We present the case of a patient with metastatic SCLC who showed both lipase and pancreatic isoamylase elevation in the absence of acute pancreatitis. Chemotherapy resulted in a rapid reduction in serum lipase and in pancreatic isoamylase which was correlated with the radiological response of the tumor to therapy. Lipase and pancreatic isoamylase expression in tumor cells from the lung biopsy was confirmed by immunohistochemical staining. Conclusions: This is a very rare case of paraneoplastic syndrome linked to metastatic SCLC. The enzymes secreted could be used as markers of response to treatment until clonal selection mechanisms and intratumor heterogeneity induce changes in biochemical characteristics and consequently in tumor behavior.

Original languageEnglish
Article number118
JournalBMC Cancer
Volume16
Issue number1
DOIs
Publication statusPublished - Feb 17 2016

Keywords

  • Pancreatic amylase
  • Paraneoplastic syndrome
  • Response marker
  • Serum lipase
  • Small-cell lung cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

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