Urologic Paraneoplastic Syndromes

R. Tiguert, Y. Fradet

14.1 Renal Cell Carcinoma 172

14.1.1 Hypercalcemia 173

14.1.2 Hypertension 174

14.1.3 Hyperglycemia 174

14.1.4 Cushing's Syndrome 174

14.1.5 Human Chorionic Gonadotropin 175

14.1.6 Hematologic Syndromes 175

14.1.7 Amyloidosis 175

14.1.8 Hepatic Syndromes 175

14.1.9 Constitutional Symptoms 176

14.1.10 Neuromuscular and Cutaneous Syndromes 176

14.2 Prostate Cancer 176

14.2.1 Inappropriate Antidiuretic Hormone Secretion 176

14.2.2 Cushing's Syndrome 177

14.2.3 Hypercalcemia 177

14.2.4 Hypophosphatemia 177

14.2.5 Human Chorionic Gonadotropin 178

14.2.6 Hematologic Syndromes 178

14.2.7 Neuromuscular and Cutaneous Syndromes 178

14.3 Bladder Cancer 179

14.3.1 Hypercalcemia 179

14.3.2 Dermatomyositis 179

14.3.3 Hematologic 179

14.4 Testicular Cancer 179

14.4.1 Gynecomastia 179

14.4.2 Dermatomyositis 180

14.5 Penile Cancer 180

14.6 Conclusion 180 References 180

Paraneoplastic syndromes represent a constellation of complex signs and symptoms that result from the release of various tumor-associated proteins rather than as a consequence of local or distant metastasis. Paraneoplastic syndromes have been estimated to occur in 15%-20% of all cancer patients. The syndromes may affect any of the systems of the body, may precede or follow the diagnosis of the underlying neoplasm, and may or may not parallel the course of the neoplasm in severity. The diagnosis and therapy for these syndromes can be challenging to a physician, but successful therapy may bring about worthwhile relief for the patient. These syndromes are important for many reasons. They occasionally aid in the early diagnosis of neoplasms, and they have aided in the discovery that many (and perhaps most) neoplasms produce hor mones or other substances that can be used as tumor markers. These markers are of increasing use in early diagnosis, in following the course of neoplasm and targeting therapy. A better understanding of the precise mechanisms involved in neoplasm production of these remote effects may help to achieve abetter understanding of the nature of the neoplastic process itself.

These peculiar paraneoplastic syndromes may be divided into endocrinologic, dermatologic, hematolog-ic, neurologic, and osteoarticular manifestations. Among the urologic cancers, renal cell carcinoma is the most often associated with paraneoplastic syndromes. In this review, the most common paraneoplastic syndromes associated with urologic cancers will be discussed.

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