Paraneoplastic syndromes (or paraneoplastic syndromes) are symptoms that accompany cancer.
These symptoms may resolve after removal of the cancer.
There are two most common mechanisms of paraneoplastic syndrome:
- secretion of hormones or growth factors/cytokines by the tumour cells or by the body as a result of the presence of the cancer,
- autoimmunity, which is the result of anti-tumour antibodies reacting with healthy tissues.
Paraneoplastic syndromes include:
Endocrine syndromes:
- excessive secretion of adrenocorticotropic hormone (Cushing's syndrome), most common in lung cancer, mainly in small cell carcinoma. Clinical manifestations: weakness, skin discolouration, diabetes mellitus.
- excessive secretion of antidiuretic hormone (ISADH syndrome), occurs mainly in lung cancers, cancers of the prostate, bladder, pancreas. Symptoms: hyponatraemia (reduced blood sodium level), low serum osmolarity, high urine osmolarity.
- hypercalcaemia - caused by the secretion of a parathormone-like protein. It accompanies squamous cell carcinomas of the lung, head and neck, bone and bone marrow metastases, lymphomas,
- hypoglycaemia - caused by the production of insulin-like growth factor by tumour cells. It accompanies mesotheliomas, retroperitoneal sarcomas.
Neurological syndromes:
- brain damage (dementias, encephalopathies, cerebellar damage),
- symptoms of medullary damage - observed in the course of small-cell lung cancer andHodgkin's lymphoma,
- peripheral neuropathy - seen in lung cancer, myeloma, Hodgkin's lymphoma,
- myasthenia gravis, accompanies thymoma,
- pseudomembranous Lambert-Eaton syndrome - most often seen in the course of small-cell lung cancer.
photo: panthermedia
Haematological syndromes:
- most commonly anaemia,
- coagulopathies,
- granulosity - squamous cell carcinoma of the lung, renal cell carcinoma,
- eosinophilia - Hodgkin's lymphoma,
- thrombocytosis - multiple tumours.
Skin lesions
- black keratosis - manifests as itchy brown patches in the armpits and groin area, most often accompanies lung and stomach cancers,
- vitiligo - occurs in patients with melanoma, sometimes accompanies lymphoma,
- numerous seborrhoeic warts - accompanies cancers of internal organs, e.g. lung, stomach,
- pruritus - in the diagnosis of malignant granuloma and tumours of the central nervous system, - blistering syndromes - usually accompanies lymphomas.
Paraneoplastic symptoms are tumour-specific. They are independent of the spread of the cancer and the size of the tumour.