Paraneoplastic syndrome

Under a paraneoplastic syndrome, also paraneoplasia (para - beside Greek, neo - Greek new, plasia - Greek education) called, is meant accompanying symptoms of cancer that do not arise primarily by the neoplasm ( solid tumors or leukemia ). The term summarizes all the symptoms that arise either by the space requirements of the tumor, or by the destruction of tissue ingrowth neoplastic cells and at the same time often are typical of a cancer.

Cause may be an immune reaction of the body, which was provoked by the cancer, or caused by the tumor release of messenger molecules (cytokines and hormones).

Some paraneoplastic syndromes are so characteristic that when they occur, should be sought after neoplasia without existing tumor diagnosis using all available diagnostic methods, in some syndromes, for example, a tumor in the lung is suspected.

Meanwhile, a variety of paraneoplastic disorders is known. Almost all organs can be affected. The compilation of this article is therefore far from complete.

  • 2.2.1 Examples of antibody-mediated paraneoplasia 2.2.1.1 blood
  • 2.2.1.2 Skin / Muscles
  • 2.2.1.3 gastrointestinal tract
  • 2.2.1.4 brain / nervous system
  • 2.2.1.5 eye

General paraneoplastic symptoms

Not rare cancer of symptoms such as cachexia, hyperthermia, anemia, leukocytosis and thrombosis are accompanied so far this must occur individually you here correctly speak of paraneoplastic symptoms, as always syndromes constitute a network with multiple symptoms.

Special paraneoplasia

Special paraneoplasia be caused by the production of hormone-like substances or immunological mechanisms. Special paraneoplastic syndromes occur in 2-15 % of cancer patients, most commonly in small cell lung cancer ( 40%).

Endocrine paraneoplastic syndromes

The production of a hormone or hormone precursors by tumor tissue simulates the existence of an endocrine disease. The exact causes are still unknown.

Examples of endocrine paraneoplasia

  • PTH ( bronchial ) ( most common endocrinological paraneoplasia )
  • ACTH ( lung cancer, hepatocellular carcinoma, renal carcinoma ). This can lead to Cushing's syndrome.
  • ADH ( small cell lung cancer, pancreatic cancer, prostate cancer)
  • TSH ( lung cancer, testicular cancer, choriocarcinoma )
  • Insulin ( hepatocellular carcinoma, pancreatic carcinoma, gastric carcinoma, insulinoma )
  • Erythropoietin ( lung cancer, uterine carcinoma, hemangioblastoma )
  • Calcitonin ( lung cancer, meduläres thyroid carcinoma, breast cancer)
  • Serotonin ( carcinoid cancer, ovarian cancer, bronchial carcinoma)

Antibody -mediated paraneoplasia

Antibody -mediated paraneoplasia arise when the immune system produces antibodies against the tumor, but at the same time, these antibodies attack healthy tissue ( cross-reactivity ). The tumor is removed, it will stop the immune response is not necessarily, and the antibodies produced can still continue damage healthy tissue. However, the prognosis of patients with antibody- associated paraneoplastic syndromes is better than the prognosis of patients without antibodies against the tumor in many cases because, although the antibodies develop on one side of its own clinical significance, also fight on the other side but the tumor. With immunosuppressive therapies is currently being experimented with.

Examples of antibody mediated paraneoplasia

Blood
  • Aplastic anemia
  • Inhibitor Hemophilia
  • Phlebitis migrans
Skin / muscles
  • Dermatomyositis
  • Subacute necrotizing myopathy
Gastrointestinal tract
  • Zollinger -Ellison syndrome
Brain / nervous system
  • Limbic encephalitis
  • Lambert- Eaton syndrome
  • Myasthenia
  • Subacute cerebellar degeneration
  • Opsoclonus - myoclonus syndrome
  • Rhombenzephalitis
  • Paraneoplastic myelitis (inflammation of the spinal cord )
  • Stiff-Man Syndrome
  • Subacute sensory neuropathy ( Denny-Brown 's syndrome)
  • Autonomic neuropathy
  • Neuromyotonia ( Isaacs syndrome)
  • Anti- NMDA receptor encephalitis
  • Paraneoplastic cerebellar atrophy (with SCLC, MammaCa, OvarialCa, lymphomas )
Eye
  • Paraneoplastic retinopathy (Cancer -associated retinopathy syndrome - CAR)

More paraneoplasia

The skin may among other things, hyperpigmentation, hyperkeratosis, hypertrichosis, acanthosis nigricans, erythema gyratum or Bullous Pemphigoid, be the heart by " non-bacterial thrombotic endocarditis ," the vascular system by repeated thrombosis affected ( for pancreatic cancer ), and the kidney by glomerular nephritis. On the skeleton is the Hypertrophic osteoarthropathy often paraneoplastic nature.

Semiochemical Organ (anatomy) Parathyroid hormone Cushing's syndrome Stomach cancer Immunosuppression Anti-NMDA receptor encephalitis Glomerulonephritis Medical guideline
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