Paraneoplastic syndromes: Difference between revisions

Latest revision as of 17:19, 1 October 2019

Background

Syndrome associated with cancer, but not due to direct, local effects of neoplasm
Result of hormones/substances secreted by malignant cells or immune response to cancer cells/products

Examples

Syndrome	Main causal cancers	Mechanism
Cushing syndrome	Small cell lung cancer, pancreatic carcinoma, neural tumors, thymoma	Ectopic ACTH/ACTH-like substance production
SIADH	Small cell lung cancer, CNS malignancies	Ectopic ADH production
Hypercalcemia	Lung (esp. SCC), breast, renal/bladder, ovarian, multiple myeloma, adult T cell leukemia/lymphoma, squamous cell carcinoma
Hypoglycemia	Sarcomas, insulinoma, hepatocellular carcinoma	Insulin/IGF production
Carcinoid syndrome	Bronchial adenoma, pancreatic and gastric carcinoma	Serotonin or bradykinin production
Hyperaldosteronism	Adrenal adenoma, non-Hodgkin's lymphoma, ovarian carcinoma, lung cancer	increased/ectopic aldosterone production
Lambert-Eaton myasthenic syndrome	Small cell lung cancer	Immune-mediated
Paraneoplastic cerebellar degeneration	Lung, ovarian, breast cancers, Hodgkin's lymphoma
Opsoclonus myoclonus syndrome	Neuroblastoma (occurs in 2-3% of peds cases), breast, ovarian, small-cell carcinoma	Autoimmune; s/sx include opsoclonus/myoclonus and other cerebellar dysfunction, aphasia, lethargy/irritability
Brain-stem or limbic encephalitis	Small cell lung cancer, germ-cell testicular tumors	Autoantibodies against intracellular neuronal proteins
Anti-NMDA receptor encephalitis	Gyn tumors (esp. teratomas)	Anti-NMDA receptor auto-antibodies
Polymyositis/Dermatomyositis	Lymphoma, lung, pancreatic, stomach, bladder, ovarian	autoimmune
Acanthosis nigricans	Gastric, lung, uterine	Epidermal growth factor secretion
Misc. derm conditions (Sweet's syndrome, Leser-Trelat sign, pyoderma gangrenosum, florid cutaneous papillomatosis, necrolytic migratory erythema, hypertrichosis)	lung, GI adenocarcinomas, breast and GU cancers, lymphoma
VTE, thrombophlebitis	any advanced cancer. Pancreatic and bronchogenic carcinomas associated w/trousseau's sign	Hypercoagulability
Polycythemia	Renal cell carcinoma, cerebellar hemangioma, hepatocellular carcinoma	Increased erythropoietin production
Granulocytosis	various	C-GSF
Membranous glomerulonephritis		tumor antigens/immune complexes
Thymoma-associated multiorgan autoimmunity	Thymoma	similar to GVHD

References

Authors:

Claire

@@ Line 14: / Line 14: @@
 | [[SIADH]]||Small cell lung cancer, CNS malignancies||Ectopic ADH production
 |-
-| [[Hypercalcemia of malignancy|Hypercalcemia]]||Lung (esp. SCC), breast, renal/bladder, ovarian, [[multiple myeloma]], adult T cell [[leukemia]]/[[lymphoma]], squamous cell carcinoma||
+| [[Hypercalcemia of malignancy|Hypercalcemia]]||Lung (esp. [[squamous cell carcinoma|SCC]]), breast, renal/bladder, ovarian, [[multiple myeloma]], adult T cell [[leukemia]]/[[lymphoma]], [[squamous cell carcinoma]]||
 |-
-| [[Hypoglycemia]]||Sarcomas, insulinoma, hepatocellular carcinoma||Insulin/IGF production
+| [[Hypoglycemia]]||Sarcomas, insulinoma, [[hepatocellular carcinoma]]||Insulin/IGF production
 |-
 | [[Carcinoid syndrome]]||Bronchial adenoma, pancreatic and gastric carcinoma||Serotonin or bradykinin production
 |-
-| Hyperaldosteronism||Adrenal adenoma, non-Hodgkin's [[lymphoma]], ovarian carcinoma, lung cancer||increased/ectopic aldosterone production
+| Hyperaldosteronism||Adrenal adenoma, [[non-Hodgkin's lymphoma]], ovarian carcinoma, lung cancer||increased/ectopic aldosterone production
 |-
 | [[Lambert-Eaton myasthenic syndrome]]||Small cell lung cancer||Immune-mediated
 |-
-| Paraneoplastic cerebellar degeneration||Lung, ovarian, breast cancers, Hodgkin's [[llymphoma]]||
+| Paraneoplastic cerebellar degeneration||Lung, ovarian, breast cancers, [[Hodgkin's lymphoma]]||
 |-
-| Opsoclonus myoclonus syndrome||Neuroblastoma (occurs in 2-3% of peds cases), breast, ovarian, small-cell carcinoma||Autoimmune; s/sx include opsoclonus/myoclonus and other cerebellar dysfunction, aphasia, lethargy/irritability
+| [[Opsoclonus]] myoclonus syndrome||[[neuroblastoma (peds)|Neuroblastoma]] (occurs in 2-3% of peds cases), breast, ovarian, small-cell carcinoma||Autoimmune; s/sx include opsoclonus/myoclonus and other cerebellar dysfunction, aphasia, lethargy/irritability
 |-
 | Brain-stem or [[limbic encephalitis]]||Small cell lung cancer, germ-cell testicular tumors||Autoantibodies against intracellular neuronal proteins
@@ Line 34: / Line 34: @@
 | [[Polymyositis]]/[[Dermatomyositis]]||[[Lymphoma]], lung, pancreatic, stomach, bladder, ovarian||autoimmune
 |-
-| Acanthosis Nigricans||Gastric, lung, uterine||Epidermal growth factor secretion
+| [[Acanthosis nigricans]]||Gastric, lung, uterine||Epidermal growth factor secretion
 |-
-| Misc. derm conditions (Sweet's syndrome, Leser-Trelat sign, pyoderma gangrenosum, florid cutaneous papilomatosis, necrolytic migratory erythema, hypertrichosis)||lung, GI adenocarcinomas, breast and GU cancers, lymphoma||
+| Misc. derm conditions (Sweet's syndrome, Leser-Trelat sign, [[pyoderma gangrenosum]], florid cutaneous papillomatosis, necrolytic migratory erythema, hypertrichosis)||lung, GI adenocarcinomas, breast and GU cancers, [[lymphoma]]||
 |-
-| [[VTE]], thrombophlebitis||any advanced cancer. Pancreatic and bronchogenic carcinomas associated w/troussau's sign||Hypercoaguability
+| [[VTE]], [[thrombophlebitis]]||any advanced cancer. Pancreatic and bronchogenic carcinomas associated w/trousseau's sign||Hypercoagulability
 |-
-| Polycythemia||Renal cell carcioma, cerebellar hemangioma, hepatocellular carcinoma||Increased erythropoiten production
+| [[Polycythemia]]||Renal cell carcinoma, cerebellar hemangioma, [[hepatocellular carcinoma]]||Increased erythropoietin production
 |-
 | Granulocytosis||various||C-GSF
 |-
-| Membranous glomerulonephritis||||tumor antigens/immune complexes
+| Membranous [[glomerulonephritis]]||||tumor antigens/immune complexes
 |-
 | Thymoma-associated multiorgan autoimmunity||Thymoma||similar to [[GVHD]]