Small cell or'oatcell' cancer ofthelung isa commondisease, foundinaboutoneinfour patients with lung cancer. Thehistological appearanceofthetumour isdistinctive; sheets ofcells with small round, ovalorfusiform nuclei andscanty cytoplasm.' Thetumourexhibits neuroendocrine (NE)features, characterized bythepresence of dense coregranules, enzymes suchasL-dopa decarboxylase andneurone specific enolase, and theproduction ofa variety ofhormones and neuropeptides. Inthemajority ofcases immunocytochemistry canidentify NE differentiation on thecell surface, orinthecytoplasm. Thedistinction ofsmall cell lungcancer fromother types oflung cancer isimportant because its clinical behaviour is sodifferent. Small cell cancer spreads early and widely throughout thebody, sothat life expectancy inuntreated cases isshort. Furthermore, small cell lung cancer ismoresensitive tochemotherapy and radiation thannon-small cell variants. Chemotherapy hasbecome thetreatment ofchoice andit hasextended themedian survival ofpatients and ledtocureinafew.2 Small cell carcinoma ofextrapulmonary origin hasbeenknowntoexist formanyyears. Thereport oftwocases ofsmall cell cancer oftheoesophagus byMcKeownin19523 hasbeenfollowed bymany further cases ofprimary small cell tumours ofthe stomach, small andlarge bowel, pancreas, salivary glands, pharynx, prostate, cervix, breast andskin. Thepericardium andbonearetwonewsites