Paraneoplastic Syndrome
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Contents |
More Specific Terms
- carcinoid syndrome
- ectopic ACTH syndrome
- erythema gyratum
- Lambert-Eaton myasthenic syndrome (LEMS)
- paraneoplastic brainstem encephalitis
- paraneoplastic cerebellar degeneration
- paraneoplastic dermatosis
- paraneoplastic limbic encephalitis
- paraneoplastic neurologic syndrome
- paraneoplastic opsoclonus myoclonus ataxia; Kinsbourne syndrome; myoclonic encephalopathy of infants; dancing eyes-dancing feet syndrome
- paraneoplastic photoreceptor retinal degeneration
- tylosis
Introduction
- Syndrome resulting from distant effects of a neoplasm.
Classification
-
- mediators:
- associated neoplasms:
- mediators:
- associated neoplasms:
- lung cancer, especially small cell carcinoma
- head & neck cancer
- mediators:
- PTH-like peptide ( PTHrP)
- parathyroid hormone (PTH)
- associated neoplasms:
- lung cancer, especially squamous cell carcinoma
- breast cancer
- myeloma
- renal cell carcinoma
- bladder cancer
- head & neck cancer
- mediators:
- serotonin ?
- substance P ?
- associated neoplasms:
- mediators:
- insulin
- insulin-like growth factors
- associated neoplasms: GI neuroendocrine tumors
- mediators:
- growth hormone-releasing hormone ( GHRH)
- growth hormone (GH)
- associated neoplasms:
- carcinoid
- small cell lung cancer
- pancreatic islet cell tumors
- mediator: chorionic gonadotropin ( hCG)
- associated neoplasms:
- neurologic (see paraneoplastic neurologic syndrome)
-
- mediator:
- associated neoplasms:
- evolution over weeks to months
- signs/symptoms
- proximal muscle weakness
- fatigability
- dry mouth
- pathology
- disruption of active zone of presynaptic terminals
- mediator:
- antibody against acetylcholine receptor subunit
- associated neoplasms: thymoma
- evolution over weeks to months
- signs/symptoms
- pathology
- disruption of postsynaptic junctional membrane folds
- muscular
-
- mediator: unknown
- associated neoplasms:
- evolution over months to years
- signs/symptoms
- pathology
- elevated serum creatine kinase
- lymphocytic infiltration of muscle interstitium
- myofiber necrosis
- phagocytosis
- necrotizing myopathy
- mediator: unknown
- associated neoplasms:
- bronchial carcinoma
- small cell lung cancer
- evolution over days to weeks
- signs/symptoms
- rapidly progressive proximal muscle weakness
- dysphagia may be present
- dyspnea
- pathology
- severe myonecrosis with minimal inflammation or phagocytosis
- skin
-
- mediator: unknown
- associated neoplasms:
-
- intra-abdominal cancer, generally gastric cancer
-
-
- adenocarcinomas, especially pancreatic & gastric
- lung cancer
- breast cancer
- genitourinary cancer
- ovarian cancer
- prostate cancer
- lymphoma
-
- adenocarcinomas, especially pancreatic & gastric
- mediator: erythropoietin
- associated neoplasms:
-
-
-
- lung cancer
- others
-
- * most common paraneoplastic syndromes
Etiology
- cause of paraneoplastic syndromes is generally autoimmune
More General Terms
References
- Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 677-678
- Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 619, 621
- Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- NINDS Paraneoplastic Syndromes Information Page [1]
- National Guideline Clearinghouse Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines. (2nd Edition) ngc-guideline: [2]
