Challenging Problems in Malignancy. CASE 1. Presentation of Small-Cell Lung Cancer With Marked Hyperamylasemia

In our case report, strong evidence indicates hyperamylasemia as a paraneoplastic phenomenon: Firstly, the marked salivary-type hyperamylasemia in the absence of inflammatory conditions of both the salivary glands and pancreas; secondly, the dramatic fall of the amylase level soon after the start of chemotherapy; and thirdly, the evidence of the strong cytoplasmic positivity with antisalivary gland type amylase antibody in the neoplastic tissue. More interestingly, in this instance, the paraneoplastic hyperamylasemia behaved like a specific tumor marker because it paralleled tumor response to chemotherapy and disease relapse.