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

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.