PETER C. WITT, M.D.; EAPEN THOMAS, M.D.
To the editor: We found the article on extrahepatic biliary obstruction caused by small-cell lung cancer, which appeared in the April issue (1), interesting. However, we were surprised by the lack of histologic documentation of the presumed pancreatic metastases. Perhaps a skinny-needle biopsy of the pancreas might have been in order. Also, because partial obstruction to the common bile duct can be caused by small stones not visible on computed tomography or ultrasound scans, endoscopic or percutaneous transhepatic cholangiography would have been valuable.
We recently saw a patient with primary small-cell carcinoma of the pancreas associated with the syndrome of
WITT PC, THOMAS E. Extrahepatic Biliary Obstruction and Small-Cell Lung Carcinoma. Ann Intern Med. ;103:476. doi: 10.7326/0003-4819-103-3-476_1
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Published: Ann Intern Med. 1985;103(3):476.
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