Metastatic small cell lung cancer presenting as acute pancreatitis: Diagnosis with magnetic resonance cholangiopancreatography

We detail a case of a right hilar small cell lung cancer with pancreatic metastases presenting as acute pancreatitis and being diagnosed on Magnetic Resonance Cholangiopancreatography (MRCP). A 59-year-old male patient had an MRCP performed following an initial computed tomography scan of the abdomen as part of the investigations following admission with acute pancreatitis. The diagnosis was not clear on CT but MRCP was able to confirm the likely diagnosis of pancreatic metastases with primary lung cancer as the underlying cause. The case illustrates the clinical radiological conundrum concurrent acute pancreatitis can produce to the diagnosis of pancreatic metastases along with how the superior tissue characterization of MRI despite the absence of intravenous contrast can be utilized to better identify solid pancreatic lesions and contribute towards the diagnosis. The superior field of view T2 coronal and localizer images on MRCP, compared to other standard abdominal imaging modalities, in this scenario enabled the right hilar lung primary to be diagnosed.