Abstract
We present the case of a 72-year-old patient admitted on various occasions with symptoms of intestinal pseudo-obstruction. Extensive diagnostic tests eventually found that the patient had small-cell lung cancer associated with high anti-HU antibody titres, which pointed to a probable paraneoplastic intestinal obstruction syndrome associated with small-cell lung cancer. A paraneoplastic syndrome causing abnormal changes in gastrointestinal motility can be the first signs of small cell lung cancer. These syndromes improve with treatment of the underlying disease, as seen in our patient, who stopped having episodes of intestinal pseudo-obstruction after administration of chemotherapy.
Highlights
A 72-year-old patient with a number of cardiovascular risk factors and chronic obstructive pulmonary disease on treatment with insulin, antihypertensive drugs, lipid-lowering drugs and bronchodilators.He came to Accident and Emergency Department with a three-day history of nausea, vomiting, intolerance of oral diet and generalised abdominal pain associated with not having passed wind or moved his bowels for eight days.The patient’s general condition was fair
With the diagnosis of small cell lung cancer with disease limited to the thorax, the patient was started on cisplatin/etoposide-based chemotherapy with concomitant radiotherapy
A paraneoplastic syndrome causing abnormal changes in gastrointestinal motility can be the first signs of small cell lung cancer.[2, 3]
Summary
The main causes of intestinal pseudo-obstruction were ruled out (Table 1): autoimmune (for not meeting criteria; ANAs, ENAs, ANCAs negative; absence of skin manifestations and normal colonoscopy), endocrine-metabolic (hormones negative), myopathy (biopsy negative), infectious causes (serology negative). With the diagnosis of small cell lung cancer with disease limited to the thorax, the patient was started on cisplatin/etoposide-based chemotherapy with concomitant radiotherapy. A paraneoplastic syndrome causing abnormal changes in gastrointestinal motility can be the first signs of small cell lung cancer.[2, 3]
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