Updated: 9/16/2021

Paraneoplastic Effects of Tumors

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  • Snapshot
    • A 62-year-old woman presents to her primary care physician with complaint of malaise and weakness for the past two months. She describes that she has difficulty getting out of a chair as well as climbing the few steps up to her front door. The patient has a 36-pack-year smoking history. Physical examination is notable for weakness in the proximal upper and lower extremities bilaterally. Laboratory studies reveal autoantibodies against voltage-gated calcium channels. A chest radiograph is obtained and shown in the image.
  • Introduction
    • Overview
      • paraneoplastic syndromes occur separately from the tumor itself, but result from substances produced by the tumor
        • symptoms may affect various body systems (i.e., endocrine, hematologic, and neuromuscular)
    • Paraneoplastic Syndromes
      Endocrine
      Syndrome or Clinical Manifestation
      Associated Tumors
      Potential Tumor Products
        Hypercalcemia
          • Squamous cell carcinomas of the lung, head, and heck
          • Renal carcinomas
          • Bladder carcinomas
          • Breast carcinomas
          • Ovarian carcinomas
          • PTHrP
          • ↑ 1,25-(OH)2 vitamin D3 (calcitriol)
            Cushing syndrome
              • Small cell lung cancer
              • ↑ ACTH
                Hyponatremia (SIADH)
                  • Small cell lung cancer
                  • ↑ ADH
                  Hematologic
                  Syndrome or Clinical ManifestationAssociated TumorsPotential Tumor Products
                    Polycythemia
                      • Renal cell carcinoma
                      • Pheochromocytoma
                      • Hemangioblastoma
                      • Leiomyoma
                      • Hepatocellular carcinoma
                      • ↑ EPO
                      Neuromuscular
                        Lambert-Eaton myasthenic syndrome
                          • Small cell lung cancer
                          • Antibodies against presynaptic Ca2+ channels at the neuromuscular junction
                            Paraneoplastic encephalomyelitis
                              • Small cell lung cancer
                              • Antibodies against Hu antigens in neurons
                                Myasthenia gravis
                                  • Thymoma
                                  • Antibodies against postsynaptic ACh receptors at the neuromuscular junction

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