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World J Clin Oncol. Aug 10, 2014; 5(3): 197-223
Published online Aug 10, 2014. doi: 10.5306/wjco.v5.i3.197
Paraneoplastic syndromes associated with lung cancer
Nobuhiro Kanaji, Naoki Watanabe, Nobuyuki Kita, Shuji Bandoh, Akira Tadokoro, Tomoya Ishii, Hiroaki Dobashi, Takuya Matsunaga
Nobuhiro Kanaji, Naoki Watanabe, Nobuyuki Kita, Shuji Bandoh, Akira Tadokoro, Tomoya Ishii, Hiroaki Dobashi, Takuya Matsunaga, Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Author contributions: Kanaji N, Watanabe N, Kita N, Bandoh S, Tadokoro A, Ishii T, Dobashi H and Matsunaga T designed the study, searched and acquired the literature and drafted and revised the manuscript.
Correspondence to: Nobuhiro Kanaji, MD, PhD, Department of Internal Medicine, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kanaji@med.kagawa-u.ac.jp
Telephone: +81-87-8912145 Fax: +81-87-8912147
Received: December 27, 2013
Revised: April 12, 2014
Accepted: May 29, 2014
Published online: August 10, 2014
Abstract

Paraneoplastic syndromes are signs or symptoms that occur as a result of organ or tissue damage at locations remote from the site of the primary tumor or metastases. Paraneoplastic syndromes associated with lung cancer can impair various organ functions and include neurologic, endocrine, dermatologic, rheumatologic, hematologic, and ophthalmological syndromes, as well as glomerulopathy and coagulopathy (Trousseau’s syndrome). The histological type of lung cancer is generally dependent on the associated syndrome, the two most common of which are humoral hypercalcemia of malignancy in squamous cell carcinoma and the syndrome of inappropriate antidiuretic hormone secretion in small cell lung cancer. The symptoms often precede the diagnosis of the associated lung cancer, especially when the symptoms are neurologic or dermatologic. The proposed mechanisms of paraneoplastic processes include the aberrant release of humoral mediators, such as hormones and hormone-like peptides, cytokines, and antibodies. Treating the underlying cancer is generally the most effective therapy for paraneoplastic syndromes, and treatment soon after symptom onset appears to offer the best potential for symptom improvement. In this article, we review the diagnosis, potential mechanisms, and treatments of a wide variety of paraneoplastic syndromes associated with lung cancer.

Keywords: Paraneoplastic syndrome, Small cell lung cancer, Non-small cell lung cancer, Symptom, Diagnosis, Treatment, Endocrine, Neurologic, Hematologic, Trousseau’s syndrome

Core tip: A wide variety of paraneoplastic syndromes are associated with lung cancer, including endocrine, neurologic, dermatologic, rheumatologic, hematologic, and ophthalmological syndromes, as well as glomerulopathy and coagulopathy (Trousseau’s syndrome). The histological type of lung cancer is generally dependent on the associated syndrome, the two most common of which are humoral hypercalcemia of malignancy in squamous cell carcinoma and the syndrome of inappropriate antidiuretic hormone secretion in small cell lung cancer. The symptoms of paraneoplastic syndromes often precede the diagnosis of lung cancer. The early detection and treatment of the underlying lung cancer offers the best outcomes for paraneoplastic syndromes.