Paraneoplastic syndromes

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Paraneoplastic syndromes

  1. 1. Paraneoplastic Syndromes Dr.CSBR.Prasad, M.D. CSBRP-DEC-2012
  2. 2. Paraneoplastic syndromesDefinition:Clinical syndromes involving nonmetastaticsystemic effects that accompany malignantdisease Nonmetastatic manifestation of malignancies CSBRP-DEC-2012
  3. 3. Paraneoplastic syndromesSymptoms:May be endocrine, neuromuscular ormusculoskeletal, cardiovascular, cutaneous,hematologic, gastrointestinal, renal, ormiscellaneous in nature Nonmetastatic manifestation of malignancies CSBRP-DEC-2012
  4. 4. Paraneoplastic syndromesMechanisms:The mechanisms of how cancers affect distantsites are not understood precisely• Cross-reacting Abs• Production of physiologically active substances• Interference with normal metabolic pathways• Idiopathic CSBRP-DEC-2012
  5. 5. Paraneoplastic syndromesThese syndromes vary from:Dermatomyositis-polymyositis toCushing syndrome to theMalignant carcinoid syndrome CSBRP-DEC-2012
  6. 6. Paraneoplastic syndromesFrequency :up to 10-15% of malignanciesMay be the first or most prominentmanifestation CSBRP-DEC-2012
  7. 7. Paraneoplastic syndromesMiscellaneous (nonspecific): Fever, anorexia, and cachexia are included in this category. Fever frequently is associated with lymphomas, acute leukemias, sarcomas, renal cell carcinomas (Grawitz tumors), and digestive malignancies (including the liver) CSBRP-DEC-2012
  8. 8. Paraneoplastic syndromesRheumatologic Arthropathies Polymyalgia [myelomas; lymphomas; leukemia] Hypertrophic osteoarthropathy [lung cancers, pleural mesothelioma, may be observed in as many as 95% of cases]SLE: Patients with lymphomas or cancers of the lung,breast, or gonads may have systemic lupuserythematosus (SLE).Secondary amyloidosis: Patients with myeloma, RCC,HD, and lymphomas CSBRP-DEC-2012
  9. 9. Paraneoplastic syndromesRenal (ACTH) or ACTH-like substances may have hypokalemic nephropathy ADH, and gut hormones may cause hypokalemia, hyponatremia or hypernatremia, hyperphosphoremia, and alkalosis or acidosis Nephrotic syndrome - Hodgkin lymphoma (HL); non-Hodgkin lymphoma (NHL); leukemias; melanomas CSBRP-DEC-2012
  10. 10. Paraneoplastic syndromesGastrointestinal:Watery diarrhea – Medullary ca of thyroid Pancreatic carcinoma Intestinal tumors CSBRP-DEC-2012
  11. 11. Paraneoplastic syndromesHematological:Trousseaus syndromeDICCryoglobulinemia (mesothelioma) CSBRP-DEC-2012
  12. 12. Paraneoplastic syndromesCutaneous:Herpes zosterIcthiosisAcanthosis nigricans CSBRP-DEC-2012
  13. 13. Acanthosis nigricans CSBRP-DEC-2012
  14. 14. Seborrhic keratosis CSBRP-DEC-2012
  15. 15. Hypertrichosis CSBRP-DEC-2012
  16. 16. Pemphigus CSBRP-DEC-2012
  17. 17. E N D CSBRP-DEC-2012

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