Paraneoplastic Effects of Lung Adenocarcinoma Causing Persistently Elevated Lipase, Amylase, and CA 19-9

Lipase, amylase, and carbohydrate antigen 19-9 are associated with pancreatic pathology. We report a rare case of a patient with persistent elevation of these markers due to paraneoplastic effects of lung adenocarcinoma. The patient presented with right upper quadrant pain and had elevated lipase, amylase, and carbohydrate antigen 19-9. Workup was unrevealing for pancreatic pathology but found a lung nodule, later confirmed as adenocarcinoma. The patient underwent chemotherapy, radiation, and immunotherapy. All levels subsequently normalized. This case underscores the importance of considering malignancy in patients with unexplained, persistent elevation of pancreatic enzymes or tumor markers in the absence of clear pancreatic pathology.