Paraneoplastic syndrome
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Paraneoplastic syndromes are diseases or symptoms caused by cancer but not by direct involvement of cancer cells. They occur in 10-15% of cancer patients and are most common in lung, breast, ovarian, and lymphoma cancers. Paraneoplastic syndromes can be divided into four main categories: endocrine, neurological, mucocutaneous, and hematological. Common examples include Cushing syndrome from ectopic ACTH production, dermatomyositis affecting the skin and muscles, and Trousseau syndrome causing blood clots.
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Paraneoplastic syndrome
- 2. • A paraneoplastic syndrome is a disease or symptom that is the consequence of cancer in the body but, not due to the local presence of cancer cells. • These phenomena are mediated by humoral factors (by hormones or cytokines) excreted by tumor cells or by an immune response against the tumor.
- 3. • They appear in 10% to 15% of patients with cancer. • Paraneoplastic syndromes are typical among middle aged to older patients, and they most commonly present with cancers of the lung, breast, ovaries or lymphatic system (a lymphoma).
- 4. • Paraneoplastic syndromes can be divided into four main categories: 1.Endocrine 2.Neurological 3.Mucocutaneous 4.Hematological
- 5. Syndrome class Syndrome Main causal cancers Causal mechanism Endocrine Hyperaldosteronism •Adrenal adenoma / Conn's syndrome •Non-Hodgkin's lymphoma •ovarian carcinoma Aldosterone Cushing syndrome •small-cell lung cancer •Pancreatic carcinoma •Thymoma Ectopic ACTH and ACTH-like substance SIADH •Small-cell lung cancer Antidiuretic hormone
- 7. Non-Hodgkin’s Lymphoma on soft palate Patients affecting with Non-Hodgkin’s Lymphoma
- 10. Syndrome class Syndrome Main causal cancers Causal mechanism Endocrine Hyperaldosteronism •Adrenal adenoma / Conn's syndrome •Non-Hodgkin's lymphoma •ovarian carcinoma Aldosterone Cushing syndrome •small-cell lung cancer •Pancreatic carcinoma •Thymoma Ectopic ACTH and ACTH-like substance SIADH •Small-cell lung cancer Antidiuretic hormone
- 14. Syndrome class Syndrome Main causal cancers Causal mechanism Endocrine Carcinoid syndrome •Bronchial adenoma (carcinoid type) •Pancreatic carcinoma •Gastric carcinoma Serotonin, Bradykinin Hypoglycemia •Fibrosarcoma •Insulinoma •Hepatocellular carcinoma Insulin or insulin- like substance or "big " IGF-II
- 18. Syndrome class Syndrome Main causal cancers Causal mechanism Paraneoplastic cerebellar degeneration • Lung • Ovarian cancer • Breast carcinoma • Hodgkin's lymphoma Neurological Lambert-Eaton myasthenic syndrome (LEMS) Small-cell lung cancer Immunologic Polymyositis •Non-Hodgkin lymphoma •lung cancers •bladder cancers
- 22. Syndrome class Syndrome Main causal cancers Causal mechanism Mucocutaneous Acanthosis nigricans •Gastric carcinoma •Lung carcinoma •Uterine carcinoma •Immunologic •Secretion of EGF Dermatomyositis •Bronchogenic carcinoma •Breast carcinoma •ovarian cancer •pancreatic cancer •stomach cancer Immunologic
- 24. Syndrome class Syndrome Main causal cancers Causal mechanism Polycythemia •Renal carcinoma •Hepatocellula r carcinoma Erythropoietin Hematological Trousseau sign •Pancreatic carcinoma •Bronchogenic carcinoma Mucins that activate clotting Anemia •Thymic neoplasms Unknown
- 26. References • Paraneoplastic Syndromes, 2011, Darnell & Posner • NINDS Paraneoplastic Syndromes Information Page National Institute of Neurological Disorders and Stroke • Darnell,R.B., DeAngelis,L.M. (1993), "Regression of small-cell lung carcinoma in patients with paraneoplastic neuronal antibodies", Lancet 341 (8836): 21–22, • Roberts,W.K., Darnell,R.B. (2004), "Neuroimmunology of the paraneoplastic neurological degenerations" • Albert,M.A., Darnell,R.B. (2004), "Paraneoplastic neurological degenerations: keys to tumour immunity", Nature Reviews Cancer 4 (1): 36– 44, PMID 14708025 • Paraneoplastic endocrine syndromes at the US National Library of Medicine Medical Subject Headings (MeSH)