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Date of Award

Spring 2024

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Sophie Farley PA-C

Abstract

Paraneoplastic syndromes are a heterogeneous group of disorders associated with neoplasms which are caused by secretion of physiologically active substances or immune-mediated tissue damage, but not due to direct tumor growth. Most commonly these syndromes are associated with small cell lung cancer. There are many different types of paraneoplastic syndromes. Paraneoplastic syndromes can be broadly classified as non-immunologic or immunologic in mechanism. First, non-immunologic syndromes such as neuroendocrine paraneoplastic syndromes are those which involve the ectopic secretion of hormones, most commonly anti-diuretic hormone and adrenocorticotropic hormone. Next, immunologic syndromes such as paraneoplastic neurologic syndromes are considered an autoimmune mediated disease process, leading to disorders such as Lambert-Eaton Myasthenic syndrome, subacute sensory neuropathy, and limbic encephalitis. While many different cancers are associated with paraneoplastic syndromes, the most common solid tumor type associated paraneoplastic syndromes is small cell lung cancer. These syndromes, while relatively uncommon, are important to identify as they can significantly impact morbidity and mortality in patients. The diversity of paraneoplastic syndromes makes them difficult to diagnose. Awareness of the clinical presentation and diagnostic criteria of paraneoplastic syndromes can help providers better treat these patients and possibly identify malignancies at an earlier stage. This article aims to increase awareness of these syndromes and expand a provider’s differential diagnosis to help patients reach a diagnosis and improve morbidity and mortality.

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Immunologic and Non-Immunologic Paraneoplastic Syndromes Associated with Small Cell Lung Cancer

Paraneoplastic syndromes are a heterogeneous group of disorders associated with neoplasms which are caused by secretion of physiologically active substances or immune-mediated tissue damage, but not due to direct tumor growth. Most commonly these syndromes are associated with small cell lung cancer. There are many different types of paraneoplastic syndromes. Paraneoplastic syndromes can be broadly classified as non-immunologic or immunologic in mechanism. First, non-immunologic syndromes such as neuroendocrine paraneoplastic syndromes are those which involve the ectopic secretion of hormones, most commonly anti-diuretic hormone and adrenocorticotropic hormone. Next, immunologic syndromes such as paraneoplastic neurologic syndromes are considered an autoimmune mediated disease process, leading to disorders such as Lambert-Eaton Myasthenic syndrome, subacute sensory neuropathy, and limbic encephalitis. While many different cancers are associated with paraneoplastic syndromes, the most common solid tumor type associated paraneoplastic syndromes is small cell lung cancer. These syndromes, while relatively uncommon, are important to identify as they can significantly impact morbidity and mortality in patients. The diversity of paraneoplastic syndromes makes them difficult to diagnose. Awareness of the clinical presentation and diagnostic criteria of paraneoplastic syndromes can help providers better treat these patients and possibly identify malignancies at an earlier stage. This article aims to increase awareness of these syndromes and expand a provider’s differential diagnosis to help patients reach a diagnosis and improve morbidity and mortality.