Chronic increased serum lipase without evidence of pancreatitis: tumor- derived lipase?

• Published in: Clinical chemistry (Baltimore, Md.) Vol. 42; no. 3; pp. 462 - 464
• Main Authors: Donnelly, JG, Ooi, DS, Burns, BF, Goel, R
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Assoc Clin Chem 01-03-1996; American Association for Clinical Chemistry
• Subjects: Abdomen; Alanine Transaminase - blood; Alkaline Phosphatase - blood; Aspartate Aminotransferases - blood; Bilirubin - blood; Biological and medical sciences; Electrophoresis, Agar Gel; gamma-Glutamyltransferase - blood; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Lipase - blood; Liver Neoplasms - secondary; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Pancreatitis - enzymology; Retroperitoneal Neoplasms - enzymology; Tumors; Human; Biological fluid; Enzyme; Triacylglycerol lipase; Esterases; Tumoral marker; Retroperitoneal disease; Carboxylic ester hydrolases; Case study; Enzymatic activity; Hydrolases; Serum; Tumor
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1093/clinchem/42.3.462

A 51-year-old man developed a large retroperitoneal tumor with liver and lymph node metastases; there was no radiological evidence of pancreatic involvement. Despite the progression of disease, results of laboratory tests, notably serum amylase, were normal except for minor increases in aspartate aminotransferase and gamma-glutamyltransferase and a marked increase in lipase. The increased lipase was not attributable to formation of macroenzyme. To determine the source of the lipase, we fractionated serum and a tumor biopsy homogenate, using electrophoresis. The lipase pattern obtained from the patient's serum differed from that seen in serum from a patient with acute pancreatitis. Additionally, the lipase pattern obtained from a homogenate of biopsy sample from the retroperitoneal tumor did not match the pattern observed for normal pancreas. Apparently, the source of this increased serum lipase activity was the nonpancreatic tumor.