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Der Internist Feb 2018Malignancies can present as inflammatory rheumatic diseases. These rheumatic paraneoplastic syndromes are rare, but characteristic in their pattern. This article focuses... (Review)
Review
Malignancies can present as inflammatory rheumatic diseases. These rheumatic paraneoplastic syndromes are rare, but characteristic in their pattern. This article focuses on epidemiology, clinical and diagnostic features as well as treatment of paraneoplasic rheumatic diseases such as paraneoplastic arthritides, vasculitides, myositis and hypertrophic osteoarthropathy. The knowledge of their clinical patterns is of utmost importance for early diagnosis and prognosis of yet undiagnosed malignancies.
Topics: Diagnosis, Differential; Early Diagnosis; Edema; Fasciitis; Hand; Humans; Myositis; Neoplasms; Osteoarthropathy, Secondary Hypertrophic; Paraneoplastic Syndromes; Prognosis; Rheumatic Diseases; Synovitis
PubMed: 29340740
DOI: 10.1007/s00108-017-0376-z -
Reumatismo Dec 2018Paraneoplastic syndromes (PS) are a heterogeneous group of diseases related to a neoplasm, indirectly dependent on it. Diagnosis and the treatment are often a challenge... (Review)
Review
Paraneoplastic syndromes (PS) are a heterogeneous group of diseases related to a neoplasm, indirectly dependent on it. Diagnosis and the treatment are often a challenge for clinicians, not least because the pathogenetic mechanisms are highly complex and not entirely known. Nonetheless, in most cases, PS precede the diagnosis of malignancies, thus their identification is particularly important in addressing physicians' diagnostic work-up with regard to early cancer diagnosis. Among paraneoplastic syndromes, those of rheumatologic interest represent a large component. In this paper, we review the main rheumatic PS.
Topics: Humans; Paraneoplastic Syndromes; Rheumatic Diseases
PubMed: 30570238
DOI: 10.4081/reumatismo.2018.1069 -
Seminars in Diagnostic Pathology Jul 2019Neuroendocrine paraneoplastic syndromes (PNS) consist of metabolic disorders that accompany benign and malignant neoplasms but remain unrelated to mass effects or... (Review)
Review
Neuroendocrine paraneoplastic syndromes (PNS) consist of metabolic disorders that accompany benign and malignant neoplasms but remain unrelated to mass effects or invasion by the primary tumor or its metastases. The underlying pathogenesis responsible for PNS usual clinical presentation relies on aberrant production of protein hormones, proteins and other substances by the tumor. Prompt recognition of characteristic signs and symptoms combined with serological identification of key substances may result in early diagnosis of PNS and its underlying malignancy. For these reasons, healthcare professionals should familiarize themselves with tumor-induced hypercalcemia, syndrome of inappropriate antidiuretic hormone, carcinoid syndrome, virilisation syndrome, gynecomastia, acromegaly, Cushing syndrome, osteogenic osteomalacia, tumor-induced hypoglycemia, necrolytic migratory erythema, and watery diarrhea, hypokalemia and achlorydria syndrome. Medical awareness for PNS can improve patient outcomes through earlier administration of cancer therapy and treatment, better symptomatic relief and prolong overall survival.
Topics: Humans; Metabolic Diseases; Neuroendocrine Tumors; Paraneoplastic Syndromes
PubMed: 30910348
DOI: 10.1053/j.semdp.2019.03.002 -
Expert Review of Gastroenterology &... May 2022Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and a significant proportion (20-40%) of patients with HCC develop paraneoplastic syndromes... (Review)
Review
INTRODUCTION
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and a significant proportion (20-40%) of patients with HCC develop paraneoplastic syndromes (PNS). Despite this, there is a paucity of clinical evidence regarding PNS in HCC.
AREAS COVERED
A systematic search was performed to identify relevant case studies regarding PNS in HCC. Another search was conducted to identify studies that evaluated the impact of PNS on survival outcomes in HCC. Since there are currently no international guidelines for PNS in HCC, this review aims to provide comprehensive summaries and recommendations of PNS in HCC, including the pathophysiology, clinical features, diagnostic approach, and management, so that clinicians remain guided in caring for HCC patients with PNS. In general, PNS are associated with poorer survival outcomes and negative prognostic markers of HCC.
EXPERT OPINION
The presence of PNS has a significant influence on survival rates and clinical outcomes of patients with HCC. They contribute to significant morbidity, influencing patients' quality of life and fitness for curative and palliative therapies. Therefore, it is paramount for PNS to be integrated into routine investigations after diagnosing HCC to guide further management and prognostication of the disease.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Paraneoplastic Syndromes; Quality of Life; Survival Rate
PubMed: 35649187
DOI: 10.1080/17474124.2022.2085556 -
Veterinary Medicine and Science Jan 2023The diagnosis of internal neoplasia in horses is challenging. Increased production of hormones physiologic for adult animals (e.g., adrenocorticotropin, norepinephrine,... (Review)
Review
The diagnosis of internal neoplasia in horses is challenging. Increased production of hormones physiologic for adult animals (e.g., adrenocorticotropin, norepinephrine, and erythropoietin) or typical for the foetal phase (alpha-fetoprotein, anti-Müllerian hormone, and parathyroid-hormone-related protein) might aid in tumour diagnostics. Thymidine kinase-1 and alkaline phosphatase are examples of intracellular enzymes, whose activity in the blood may increase in some neoplasia cases. Furthermore, inappropriate production of abnormal monoclonal or autologous antibodies can accompany lymphoma and multiple myeloma. Many of those tumour markers lead to clinical or laboratory changes, called paraneoplastic syndromes, such as hypercalcaemia and erythrocytosis. The interpretation of the results of the tumour marker measurements in horses is complicated due to many factors affecting the markers' concentration or activity (e.g., young age, pregnancy, and inflammation) and other diseases triggering the same changes. Moreover, the presence of paraneoplastic syndromes is inconsistent, which leads to low sensitivity of those substances as tumour markers. In conclusion, screening for neoplasia in horses is not recommended. The measurement of tumour markers should be performed only in risk groups with suspicious clinical or laboratory findings, and the results should be interpreted with caution. It is advisable to add inflammatory markers to the tumour profile or repeat the measurements.
Topics: Horses; Animals; Paraneoplastic Syndromes; Biomarkers, Tumor; Lymphoma; Inflammation; Horse Diseases
PubMed: 36495211
DOI: 10.1002/vms3.1042 -
Postepy Higieny I Medycyny... Jul 2014Paraneoplastic syndromes, which are discussed in this paper, are a heterogeneous group of disorders associated with cancer, but not directly caused by the physical... (Review)
Review
Paraneoplastic syndromes, which are discussed in this paper, are a heterogeneous group of disorders associated with cancer, but not directly caused by the physical effects of the primary tumor or its metastases. May precede the appearance of the malignant process, occur simultaneously or disclose in the course of cancer. Paraneoplastic syndromes may be caused directly by toxins produced by tumor cells, occur in the course of hypersensitivity reactions, or be the result of release of intracellular antigens. Due to the often similar systemic symptoms it is very important to evaluate the association of rheumatic diseases and cancer. Most paraneoplastic rheumatologic syndroms are difficult distinguishable from idiopathic rheumatologic disorders. The most common paraneoplastic syndromes include rheumatoid arthritis (RA)-like syndrome arthritis, inflammatory myopathies, hypertrophic osteoarthropathy, vasculitis and Raynaud's phenomenon.
Topics: Arthritis, Rheumatoid; Diagnosis, Differential; Humans; Myositis; Osteoarthropathy, Primary Hypertrophic; Paraneoplastic Syndromes; Raynaud Disease; Vasculitis
PubMed: 25055033
DOI: 10.5604/17322693.1111924 -
Annales de Dermatologie Et de... Nov 2017
Review
Topics: Acantholysis; Autoimmune Diseases; Humans; Keratosis, Seborrheic; Paraneoplastic Syndromes; Pemphigus; Precancerous Conditions; Skin Diseases, Genetic; Skin Diseases, Infectious; Skin Diseases, Vesiculobullous; Skin Neoplasms
PubMed: 28784249
DOI: 10.1016/j.annder.2017.05.002 -
Seminars in Diagnostic Pathology Jul 2019Paraneoplastic syndromes (PNS) are rare clinical syndromes due to the systemic effects of tumours; they are unrelated to tumour size, invasiveness or metastases. Recent... (Review)
Review
Paraneoplastic syndromes (PNS) are rare clinical syndromes due to the systemic effects of tumours; they are unrelated to tumour size, invasiveness or metastases. Recent years have seen considerable advances leading to improved understanding of their pathophysiology and increased recognition of new PNS entities and PNS associated tumours. While of paramount importance, diagnosis is still frequently missed or delayed. Diverse organs and systems are affected by the associated tumours- which may be benign or malignant. PNS can occur concurrently with tumour diagnosis, before tumour is diagnosed and even after tumours have been resected. Also, there are autoimmune diseases later progressing to PNS when occult tumours are identified. Another confounding factor is that many PNS clinically resemble non-neoplastic diseases. PNS are largely due to two main causes: those due to tumour secretions of hormones, functionally active peptides, enzymes cytokines or to tumours operating through auto-immune/immunological mechanisms with cross-reacting antibodies between neoplastic and normal tissues. Remission of symptoms often follows resection of humoral secretory tumours but not always of tumours due to immunological mechanisms. Classifications schemes vary but most currently place PNS in one of five groups: endocrine, neurological, musculocutaneous, haematological and other. Due to advances both in diagnostic techniques in identifying tumours as well as in therapy, early diagnosis not only results in improved prognosis of both PNS and associated tumours but also enables monitoring response to treatment and early detection of recurrence. This article covers definition, general principals of classification, diagnosis, pathophysiology and treatment, with emphasis on tumour related PNS serving as an introduction to the following articles.
Topics: Humans; Paraneoplastic Syndromes
PubMed: 30876820
DOI: 10.1053/j.semdp.2019.01.002 -
Best Practice & Research. Clinical... May 2022Paraneoplastic syndromes denote rare but notable phenomena caused by the tumour mediated release of bioactive substances. Peptide and non-peptide hormone causes are... (Review)
Review
Paraneoplastic syndromes denote rare but notable phenomena caused by the tumour mediated release of bioactive substances. Peptide and non-peptide hormone causes are explored with a particular focus on pathogenesis, symptoms, diagnosis and treatment. Early detection and management of paraneoplastic syndromes can improve morbidly and mortality; definitive treatment remains effective surgical or anti-tumour therapies. Pituitary autoimmunity may provide a novel presentation of paraneoplastic syndromes for which further research is warranted.
Topics: Endocrine System Diseases; Humans; Neoplasms; Paraneoplastic Endocrine Syndromes; Paraneoplastic Syndromes; Pituitary Diseases
PubMed: 35153144
DOI: 10.1016/j.beem.2022.101621 -
Clinics in Dermatology 2023Annular and acral/facial dyskeratotic paraneoplastic disorders are inflammatory dermatoses that occur in association with distant cancers but are not precursors,...
Annular and acral/facial dyskeratotic paraneoplastic disorders are inflammatory dermatoses that occur in association with distant cancers but are not precursors, extensions, or metastases of them. There are four classical entities under this rubric: two gyrate entities, erythema annulare centrifugum and erythema gyratum repens, and two acral/facial dyskeratotic entities, acrokeratosis paraneoplastic (Bazex syndrome) and tripe palms. Each of these entities may also occur in association with another etiopathogenesis and may present either as a classical entity or as a barely recognizable disease. We discuss these entities, their associated causes, and their differential diagnoses in turn.
Topics: Humans; Erythema; Skin; Skin Neoplasms; Skin Diseases, Genetic; Paraneoplastic Syndromes
PubMed: 37423265
DOI: 10.1016/j.clindermatol.2023.07.008