# Catecholamine-Secreting Non-small Cell Lung Cancer Presenting With Hypertensive Crisis: A Report of a Rare Case

## TL;DR

A rare case of non-small cell lung cancer causing a hypertensive crisis due to catecholamine production is reported.

## Contribution

The first reported case of catecholamine-secreting non-small cell lung cancer leading to a hypertensive crisis.

## Key findings

- A 68-year-old woman with lung adenocarcinoma presented with a hypertensive crisis due to elevated normetanephrine levels.
- The case highlights the challenges of managing paraneoplastic syndromes in advanced cancer patients.
- The patient's condition led to poor treatment tolerance and transition to hospice care.

## Abstract

Ectopic catecholamine production by non-small cell lung cancer (NSCLC) is exceptionally rare and, to our knowledge, has not been previously reported in the literature. We present the case of a 68-year-old woman with advanced lung adenocarcinoma who presented in hypertensive crisis due to markedly elevated normetanephrine levels. Initial suspicion was for pheochromocytoma, but normal chromogranin A levels suggested a paraneoplastic phenomenon. Despite alpha-adrenergic blockade, the patient’s metastatic disease and refractory hypertension contributed to poor treatment tolerance, ultimately necessitating transition to hospice care. This case underscores the importance of considering atypical endocrine manifestations of NSCLC and highlights the challenges of managing advanced cancer complicated by paraneoplastic syndromes.