Malignancy-associated gastroparesis: an important and overlooked cause of chronic nausea and vomiting

BMJ Case Rep. 2014 Feb 10;2014:bcr2013201815. doi: 10.1136/bcr-2013-201815.

Abstract

A 69-year-old woman was referred to a gastroenterology clinic with a 1-year history of protracted nausea and postprandial vomiting. She had a background of gastro-oesophageal reflux disease, irritable bowel syndrome and chronic obstructive pulmonary disease with a significant smoking history. Her laboratory work-up including autoimmune screen, coeliac serology and synacthen test were unremarkable. Upper gastrointestinalendoscopy and CT imaging ruled out mucosal and obstructive causes. Gastric emptying studies demonstrated a delayed gastric emptying consistent with diagnosis of gastroparesis. Concurrently, she underwent a CT of the thorax for unresolved consolidation on her chest X-ray. This revealed a locally advanced primary lung carcinoma. In this context, with all other causes excluded, her gastroparesis was deemed to represent a paraneoplastic phenomenon. Gastroparesis is a frequent, under-recognised and important complication of cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / complications*
  • Carcinoma, Squamous Cell / diagnosis
  • Female
  • Gastroparesis / etiology*
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / diagnosis
  • Nausea / etiology
  • Paraneoplastic Syndromes / complications
  • Paraneoplastic Syndromes / diagnosis
  • Paraneoplastic Syndromes / etiology
  • Vomiting / etiology*