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Nobuaki Ochi1, Nagio Takigawa1, Masayuki Yasugi1, Etsuji Ishida2, Hirofumi Kawamoto2, Akihiko Taniguchi1, Daijiro Harada1, Eiko Hayashi3, Hiroko Toda3, Hiroyuki Yanai3, Mitsune Tanimoto1, Katsuyuki Kiura11Department of Hematology, Oncology and Respiratory Medicine, 2Department of Gastroenterology and Hepatology, 3Department of Pathology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanAbstract: Obstructive jaundice sometimes may develop in association with advanced small-cell lung cancer (SCLC); however, SCLC initially presenting with obstructive jaundice is rare. This report presents the cases of two SCLC patients with obstructive jaundice at the initial diagnosis. A 64-year-old male presented with obstructive jaundice due to a tumor at the head of the pancreas. He was diagnosed with SCLC by transbronchial biopsy from a lung tumor in the left upper lobe. Another 74-year-old male was admitted with jaundice due to a tumor in the porta hepatis. He was also diagnosed with SCLC by a fine-needle aspiration biopsy of a lung tumor in the left lower lobe. Both cases were successfully treated with systemic chemotherapy after endoscopic retrograde biliary drainage.Keywords: small-cell lung carcinoma, jaundice, biliary obstruction, metastasis