Paraneoplastic syndromes

Endocrine paraneoplastic syndromes 546 Neurological paraneoplastic syndromes 548 Haematological paraneoplastic syndromes 550 Dermatological paraneoplastic syndromes 552 Other syndromes 554 Constitutional symptoms 556 Further reading 557

These pathological conditions are caused by a cancer but are not due to direct local infiltration or metastatic spread. Occurring in approximately 10% of cancer patients overall, they are most commonly associated with certain cancer types. They are important to recognize because they may be the presenting feature of an undiagnosed cancer. Paraneoplastic syndromes (PS) can also cause significant morbidity that may be treatable, and they may sometimes act as markers of disease activity.

Cancers commonly associated with paraneoplastic syndromes (PS):

♦ Lung: small cell (SCLC) and non-small cell (NSCLC)

♦ Pancreatic

♦ Lymphoma: non-Hodgkin's (NHL) and Hodgkin's Disease (HD)

Although the mechanisms of PS are not fully understood, there appear to be two main causes:

♦ The inappropriate secretion of hormones and/or growth factors

♦ The production of anti-tumoural antibodies that cross-react with normal tissue antigens

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