Overview of Paraneoplastic Syndrome
Paraneoplastic syndrome, also known as concomitant cancer syndrome, refers to a group of clinical syndromes that are not directly related to the tumor but are caused by the metabolic abnormality of the tumor itself or various effects on the body, in addition to the common symptoms and signs of the cancer itself. Paraneoplastic syndromes can occur at any period of cancer development, including corresponding clinical symptoms in skin, endocrine, neurological, hematological, urinary and other systems.
Etiology
It is related to tumor metabolites (e.g. production of ectopic hormones) and the effect of tumor on the body, abnormal immune response, etc.
Symptoms
1. Systemic symptoms
The symptoms are anorexia, weight loss, fatigue, and cannot be improved by increasing caloric supplementation.
2. Abnormal blood sugar metabolism
Manifested as hypoglycemia or hyperglycemia.
3. Abnormal water and electrolyte metabolism
The manifestation is hypercalcemia, with blurred consciousness, weakness, fatigue, depression, drowsiness, anorexia, nausea and vomiting.
4. Abnormal endocrine metabolism
Hyperlipidemia, hyperadrenocorticism, hyperthyroidism, etc. may appear.
5. Rheumatic diseases
Such as hypertrophic osteoarthropathy, manifested as one or more joint inflammation of the distal joints and finger (toe) pestle change, distal long bones painful osteochondritis, non-inflammatory synovial exudation.
6. Nervous system lesions
The manifestations are spinal cord, peripheral neuropathy, myasthenia gravis, etc.
7. Blood system changes
The manifestations are platelet and red blood cell abnormalities, disseminated intravascular coagulation, hyperfibrinogenemia, bleeding and thrombosis.
8. Changes in digestive system
Nausea, vomiting, abdominal pain, constipation and so on.
9. Others
May manifest as rash, fever, gynecomastia, etc.
Examination
As paraneoplastic syndrome is a group of clinical syndromes in endocrine or metabolic aspect directly related to non-tumor. The examination items should be selected according to the clinical manifestations of patients. Routine examination includes blood and urine routine, blood biochemistry examination, etc. X-ray, B-mode ultrasound or CT examination should be performed when necessary. In addition, tumor markers, such as alpha-fetoprotein, should be tested for the tumor.
Diagnosis
Paraneoplastic syndrome can occur at any period of cancer development. Combined with the patient’s clinical manifestations, if some clues of cancer can be detected, an early and correct diagnosis can be made.
Treatment
According to the site of lesion and clinical manifestation, appropriate treatment will be chosen.