Target: UG medical students.

1. Paraneoplastic Syndromes
Dr.CSBR.Prasad, M.D.
CSBRP-DEC-2012

2. Paraneoplastic syndromes
Definition:
Clinical syndromes involving nonmetastatic
systemic effects that accompany malignant
disease
Nonmetastatic manifestation of malignancies
CSBRP-DEC-2012

3. Paraneoplastic syndromes
Symptoms:
May be endocrine, neuromuscular or
musculoskeletal, cardiovascular, cutaneous,
hematologic, gastrointestinal, renal, or
miscellaneous in nature
Nonmetastatic manifestation of malignancies
CSBRP-DEC-2012

4. Paraneoplastic syndromes
Mechanisms:
The mechanisms of how cancers affect distant
sites are not understood precisely
• Cross-reacting Abs
• Production of physiologically active substances
• Interference with normal metabolic pathways
• Idiopathic
CSBRP-DEC-2012

5. Paraneoplastic syndromes
These syndromes vary from:
Dermatomyositis-polymyositis to
Cushing syndrome to the
Malignant carcinoid syndrome
CSBRP-DEC-2012

6. Paraneoplastic syndromes
Frequency :
up to 10-15% of malignancies
May be the first or most prominent
manifestation
CSBRP-DEC-2012

7. Paraneoplastic syndromes
Miscellaneous (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. Paraneoplastic syndromes
Rheumatologic
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 lupus
erythematosus (SLE).
Secondary amyloidosis: Patients with myeloma, RCC,
HD, and lymphomas CSBRP-DEC-2012

9. Paraneoplastic syndromes
Renal
(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. Paraneoplastic syndromes
Gastrointestinal:
Watery diarrhea –
Medullary ca of thyroid
Pancreatic carcinoma
Intestinal tumors
CSBRP-DEC-2012

11. Paraneoplastic syndromes
Hematological:
Trousseaus syndrome
DIC
Cryoglobulinemia (mesothelioma)
CSBRP-DEC-2012

12. Paraneoplastic syndromes
Cutaneous:
Herpes zoster
Icthiosis
Acanthosis nigricans
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13. Acanthosis nigricans
CSBRP-DEC-2012

14. Seborrhic keratosis
CSBRP-DEC-2012

15. Hypertrichosis
CSBRP-DEC-2012

16. Pemphigus
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17. E N D
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