A case of small-cell carcinoma of the lungs with chylous ascites

Abstract

Background: It has been reported that patients with lung cancer sometimes have chylothorax; however, there are few reports of lung cancer patients with chylous ascites. Case: A 56-year-old male with smallcell carcinoma of the lungs was treated with concurrent chemoradiotherapy. A complete response was obtained after treatment, although recurrence to the brain, liver, adrenal glands and abdominal lymph nodes was noted in June 2011. Four courses of second-line chemotherapy were commenced with carboplatin and etoposide, which achieved stable disease. In November 2011, the patient presented with dyspnea and a fever and was admitted with a diagnosis of pneumonia. The administration of antibiotics led to an improvement in his symptoms; however, abdominal pain and distension were subsequently observed, and massive ascites was detected in December 2011. Abdominal paracentesis showed milky ascites with a higher triglyceride level than that measured in the blood; therefore, the ascites was diagnosed as chylous ascites. We were unable to identify any sites of leakage from the lymph ducts on lymphoscintigraphy; however, contrast CT revealed bulky abdominal lymphadenopathy due to metastasis. Therefore, the disruption of the normal lymphatic flow due to abdominal lymphadenopathy was considered to have caused the chylous ascites. Subsequently, the patient underwent diet treatment and chemotherapy consisting of amrubicin, and the ascites resolved. Conclusion: We herein reported a rare case of smallcell lung cancer with chylous ascites caused by abdominal lymph node metastasis. © 2013 The Japan Lung Cancer Society.