Updated: 4/11/2022

Paraneoplastic Effects of Tumors

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  • Snapshot
    • A 69-year-old man presents to his physician with complaint of malaise for the past 2 months. He also has a unrelenting cough that is bothersome to him and keeps him from sleeping well at night. In addition, he realized that he had unintentionally lost 18 pounds in the past months after weighing himself when his wife remarked that he looked thinner than usual. The patient has a 40 pack-year smoking history. Labs are drawn and he is found to have an elevated serum sodium level of 120 mEq/L. A chest radiograph is obtained and shown in the image.
  • Introduction
    • Overview
      • paraneoplastic syndromes occur separately from the tumor itself, but result from substances produced by the tumor
        • symptoms may affect various body systems (i.e., endocrine, hematologic, neuromuscular)
  • Paraneoplastic Syndromes
    Endocrine
    Syndrome or Clinical Manifestation
    Associated Tumors
    Potential Tumor Products
    HypercalcemiaSquamous cell carcinomas of the lung, head, and neck Renal carcinomasBladder carcinomasBreast carcinomasOvarian carcinomas PTHrP↑ 1,25-(OH)2 vitamin D3 (calcitriol)
    Cushing syndrome
    Small cell lung cancer
    ↑ ACTH
    Hyponatremia (SIADH)
    Small cell lung cancer
    ↑ ADH
    Hematologic
    Syndrome or Clinical ManifestationAssociated TumorsPotential Tumor Products
    Polycythemia
    Renal cell carcinomaPheochromocytomaHemangioblastomaLeiomyomaHepatocellular carcinoma
    ↑ EPO
    Neuromuscular
    Lambert-Eaton myasthenic syndromeSmall cell lung cancerAntibodies against presynaptic Ca2+ channels at the neuromuscular junction
    Paraneoplastic encephalomyelitis
    Small cell lung cancer
    Antibodies against Hu antigens in neurons
    Myasthenia gravis
    Thymoma
    Antibodies against postsynaptic ACh receptors at the neuromuscular junction

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