Small cell lung cancer (SCLC) is an aggressive, high-grade neuroendocrine neoplasm that possesses distinctive genetic features and clinical properties, has a highly reliable pathological diagnosis and responsiveness to specific chemotherapy. SCLC frequently presents with early metastasis, which confers a morbid prognosis. Herein we describe a 65-year-old male patient, whose preliminary investigations revealed primary SCLC with metastatic neuroendocrine carcinoma of the liver and anemia. Further analysis and a meticulous search for the unexplained anemia at diagnosis, revealed synchronous hepatic and skeletal metastases with primary small cell carcinoma of the lung. These conditions are uncommon and seldom described in the literature.
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