Paraneoplastic syndrome


Paraneoplastic syndrome

Description, Causes and Risk Factors:

Abbreviation: PS.

A syndrome directly resulting from a malignant neoplasm, but not resulting from the presence of tumor cells in the affected parts. PS may affect any portion of the nervous system (cerebral cortex, brainstem, spinal cord, peripheral nerves, neuromuscular junction, and muscle).

Although the pathogenesis remains unclear, antibodies and T-cell responses are believed to be important for many of these disorders.

Clinically significant PS probably occurs in fewer than 1% of patients with cancer. These disorders typically affect middle-aged to older persons. If a patient without a known cancer presents with one of the classic PS the likelihood he/she has cancer is considerable.

The most common cancers associated with PS are those arise from the lung, renal carcinoma, hepatocellular carcinoma, leukemias, lymphomas, breast and ovarian tumors, gastric and pancreatic tumors, and neural cancers.

Symptoms:

Some common symptoms include:

    Difficulty in walking.

  • Difficulty swallowing.

  • Loss of muscle tone.

  • Loss of fine motor coordination.

  • Slurred speech.

  • Vision problems.

  • Memory loss.

  • Sleep disturbances.

  • Seizures.

  • Vertigo or dizziness.

Diagnosis:

Patients with a suspected PS should receive a complete panel of laboratory studies including CBC, urine analysis, and cerebrospinal fluid (CSF) analysis.Imaging studies may include CT scan and MRI scans.PET and SPECT scans may also needed for evaluation of patient with underlying neurological disorder.

Diagnosis with known cancer:

Search for metastases:

  • MRI of involved site.

  • CSF cytology.

Search for nonmetastatic disorders:

  • Vascular, infectious, metabolic disorders, chemotherapy, radiation therapy.

  • Serum/CSF for autoantibodies.

Diagnosis without known cancer:

    CXR (Chest x-ray), pelvic examination.

  • Mammograms, examine lymph nodes, serum cancer markers (CEA).

  • CSF for cells, IgG, OCB, cytology examination.

  • Serum/CSF for autoantibodies.

Treatment:

The goal of the treatment for paraneoplastic syndrome is actually connected to eradication of the underlying cancer since this will be efficient in elimination of the symptoms. There are usually two approaches taken in the treatment of paraneoplastic syndromes. The first step is treatment of the cancer that is causing the syndrome. This treatment can be surgery, administration of chemotherapy, radiation therapy, biotherapy, or a combination of these therapies. The next approach is to suppress the substance or mediator causing the paraneoplastic syndrome. Often treatment targeted to the underlying cancer and to the paraneoplastic syndrome occur at the same time, however, even with treatment, irreversible damage to the target organ can occur. Scientists are also developing new animal models for these diseases, which may be used to determine effective treatment strategies.

Note:The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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