Condition Lookup
Sub-Category:
Paraneoplastic Syndromes
Number of Conditions: 5
Hypercalcemia of Malignancy
Specialty: Oncology
Category: Sarcomas
Sub-category: Paraneoplastic Syndromes
Symptoms:
nausea; vomiting; constipation; abdominal pain; fatigue; confusion; thirst; frequent urination; muscle weakness
Root Cause:
Malignant tumors release calcium into the bloodstream, often through secretion of parathyroid hormone-related protein (PTHrP) or osteolytic bone metastasis.
How it's Diagnosed: videos
Blood tests showing elevated calcium levels, alongside confirmation of underlying malignancy through imaging or biopsy.
Treatment:
Hydration, bisphosphonates (such as zoledronic acid), denosumab, corticosteroids, and calcitonin.
Medications:
Bisphosphonates (e.g., zoledronic acid) inhibit bone resorption, and denosumab , a monoclonal antibody, works by inhibiting osteoclast activity. Corticosteroids (e.g., dexamethasone ) may be used if there is an underlying hematologic malignancy. Calcitonin helps to lower calcium levels by inhibiting osteoclast function.
Prevalence:
How common the health condition is within a specific population.
Affects approximately 10-20% of patients with advanced cancer.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Patients with lung, breast, or hematologic cancers, and those with extensive bone metastasis.
Prognosis:
The expected outcome or course of the condition over time.
The prognosis depends on the underlying malignancy and the ability to control calcium levels. Treatment of the underlying cancer can improve the prognosis.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
Severe hypercalcemia can cause kidney failure, arrhythmias, coma, and, if untreated, death.
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
Specialty: Oncology
Category: Sarcomas
Sub-category: Paraneoplastic Syndromes
Symptoms:
hyponatremia; nausea; vomiting; confusion; seizures; lethargy; muscle cramps
Root Cause:
Tumors produce excess antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia.
How it's Diagnosed: videos
Blood tests showing low sodium levels and high urine osmolality despite low serum osmolality. Imaging to identify the tumor may also be necessary.
Treatment:
Fluid restriction, hypertonic saline in severe cases, and vasopressin receptor antagonists (e.g., tolvaptan). Treating the underlying cancer may improve SIADH.
Medications:
Vasopressin receptor antagonists (e.g., tolvaptan ) help correct sodium imbalances by blocking the effects of ADH.
Prevalence:
How common the health condition is within a specific population.
Common in patients with small cell lung cancer, as well as other malignancies like head and neck cancers.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Small cell lung cancer, brain tumors, and medications such as cyclophosphamide or vincristine.
Prognosis:
The expected outcome or course of the condition over time.
Prognosis depends on the underlying malignancy and successful management of fluid imbalances.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
If untreated, SIADH can lead to severe hyponatremia, seizures, and coma.
Cushing Syndrome (Ectopic ACTH Production)
Specialty: Oncology
Category: Sarcomas
Sub-category: Paraneoplastic Syndromes
Symptoms:
weight gain; moon face; central obesity; purple striae; osteoporosis; muscle weakness; hypertension; hyperglycemia
Root Cause:
Tumors, often lung carcinoid or small cell lung cancer, secrete adrenocorticotropic hormone (ACTH), stimulating excess cortisol production.
How it's Diagnosed: videos
Elevated cortisol levels in the blood or urine, ACTH levels are often high, and imaging may identify the tumor.
Treatment:
Surgical removal of the tumor, if possible. Medications like ketoconazole or metyrapone can inhibit cortisol production, and mitotane may be used to suppress adrenal function.
Medications:
Medications like ketoconazole (a steroidogenesis inhibitor) and metyrapone (inhibits cortisol synthesis) can be used to control excess cortisol production.
Prevalence:
How common the health condition is within a specific population.
Rare, but occurs in up to 10% of patients with ectopic ACTH-producing tumors.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Small cell lung cancer, bronchial carcinoid tumors, or pancreatic tumors.
Prognosis:
The expected outcome or course of the condition over time.
Prognosis varies with tumor type; successful tumor removal can lead to remission, though recurrence is possible.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
Osteoporosis, cardiovascular disease, diabetes, and infections due to prolonged cortisol excess.
Lambert-Eaton Myasthenic Syndrome
Specialty: Oncology
Category: Sarcomas
Sub-category: Paraneoplastic Syndromes
Symptoms:
muscle weakness; difficulty standing up; dry mouth; blurry vision; fatigue; constipation; impaired reflexes
Root Cause:
Autoimmune attack on presynaptic calcium channels at the neuromuscular junction, often associated with small cell lung cancer.
How it's Diagnosed: videos
Clinical symptoms, electromyography (EMG) showing impaired neuromuscular transmission, and detection of antibodies against voltage-gated calcium channels.
Treatment:
Treatment involves immunosuppressive therapy (e.g., corticosteroids, azathioprine), plasmapheresis, and possibly 3,4-diaminopyridine.
Medications:
Immunosuppressive agents like corticosteroids (e.g., prednisone ), azathioprine , and 3,4-diaminopyridine to improve neuromuscular transmission.
Prevalence:
How common the health condition is within a specific population.
Rare, typically associated with small cell lung cancer in 50-70% of cases.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Small cell lung cancer, other cancers like prostate or thyroid cancer.
Prognosis:
The expected outcome or course of the condition over time.
The prognosis is dependent on the underlying malignancy and response to treatment. Symptoms may improve with cancer treatment.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
Respiratory failure, difficulty swallowing, and persistent muscle weakness.
Neuromyelitis Optica (Anti-Aquaporin-4 Antibody Syndrome)
Specialty: Oncology
Category: Sarcomas
Sub-category: Paraneoplastic Syndromes
Symptoms:
vision loss; optic neuritis; nausea; vomiting; paralysis; sensory disturbances; bladder dysfunction; extreme fatigue
Root Cause:
Autoimmune response against aquaporin-4 channels on astrocytes, causing inflammation of the optic nerve and spinal cord, often associated with malignancies.
How it's Diagnosed: videos
Detection of anti-AQP4 antibodies in the blood, MRI showing spinal cord and optic nerve lesions, and clinical presentation.
Treatment:
High-dose corticosteroids, plasmapheresis, and rituximab (an immunosuppressive therapy).
Medications:
Corticosteroids (e.g., methylprednisolone ), rituximab (a monoclonal antibody), and plasmapheresis may be used to manage acute relapses.
Prevalence:
How common the health condition is within a specific population.
Rare, with an estimated 2-4 cases per million people annually.
Risk Factors:
Factors or behaviors that increase the likelihood of developing the condition.
Associated with autoimmune diseases, and may be paraneoplastic in some cases linked to cancers such as breast, lung, and ovarian.
Prognosis:
The expected outcome or course of the condition over time.
Relapsing-remitting course in some patients; poor prognosis with significant long-term disability if untreated.
Complications:
Additional problems or conditions that may arise as a result of the original condition.
Vision loss, paralysis, and in severe cases, respiratory failure due to spinal cord involvement.