Paraneoplastic syndromes in patients with primary head and neck cancer

Abstract

Paraneoplastic syndromes represent the clinical manifestations of the indirect and remote effects produced by tumor metabolites or other products. The clinical spectrum of the various paraneoplastic syndromes related to primary malignancies of the head and neck region is presented. A review of the literature on paraneoplastic syndromes in patients with primary head and neck cancer was carried out. Paraneoplastic syndromes related to primary malignancies of the head and neck region can be categorized as: endocrine, cutaneous or dermatologic, hematologic, neurologic, osteoarticular or rheumatologic, ocular syndromes. Sometimes, paraneoplastic syndromes can be more serious than the consequences of the primary tumor itself and can precede, follow or be concurrent to the diagnosis of a malignancy; moreover, they can dominate the clinical picture and thus lead to errors with respect to the origin and type of the primary tumor. Physicians who deal with cancer-associated syndromes should be able to differentiate the paraneoplastic syndromes from the benign disorders that mimic them. Patients with a suspected paraneoplastic disorder should undergo a complete panel of laboratory studies, in addition to imaging studies and endoscopy. Identification of paraneoplastic syndromes allow the clinician to make an early diagnosis and to provide adequate treatment of tumors, with a favorable oncologic outcome and improved life expectancy for the patient. These syndromes can follow the clinical course of the tumor and thus be useful for monitoring its evolution.

Galactorrhea, mastodynia and gynecomastia as the first manifestation of lung adenocarcinoma. A case report

“…Paraneoplastic syndromes (PNS) represent a clinical spectrum of manifestations of the indirect and remote effects produced by tumor metabolites or other products and exclude metastasis or any other normal events associated with tumor progression [16]. It is reported that 7.4% of all cancers have PNS associated with them.…”

Incidencia y características clínicas y epidemiológicas del carcinoma de nasofaringe en Cantabria en 2014

“…Nuestros resultados revelan que estos últimos fueron los más frecuentes, seguidos de las adenopatías cervicales y la sintomatología nasal. A destacar en nuestra serie, un paciente presentó una mielitis paraneoplásica, de ahí la importancia de valorar la posibilidad de un síndrome paraneoplásico en pacientes con cánceres de cabeza y cuello que presenten sintomatología neurológica subaguda [22].…”

Leukemoid reaction as a paraneoplastic syndrome in hypopharyngeal squamous cell carcinoma with cutaneous metastasis: an exceedingly rare occurrence

“…These are most commonly endocrine, such as SIADH, hypercalcaemia and gynaecomastia, and dermatological manifestations, such as acanthosis nigricans, Bazex syndrome and Sweets syndrome,13 with haematological manifestations being exceedingly rare. Nonetheless, they may be important as they might be the first clinical manifestation and could help raise suspicion of an underlying tumour,14 especially in high-risk patients who manifest with abnormalities such as anaemia, thrombocytosis, disseminated intravascular coagulation or leukemoid reactions 15. There are several hypotheses put forward to explain these manifestations, including interference with vitamin B 6 and B 12 metabolism, presence of an anti-erythropoietin factor and excessive motivation of humoral stimulation for haemopoiesis by blastic factors produced by tumour necrosis 16.…”