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 cance...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, cyto-kines, 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.展开更多
In rare instances, stroke may preceed a diagnosis of cancer and be the first clinical evidence of an underlying malignancy.Cerebral infarction mostly complicates lymphomas, carcinomas, and solid tumors. Malignancy-rel...In rare instances, stroke may preceed a diagnosis of cancer and be the first clinical evidence of an underlying malignancy.Cerebral infarction mostly complicates lymphomas, carcinomas, and solid tumors. Malignancy-related thromboembolism can present as acute cerebral infarction, nonbacterial thrombotic endocarditis and migratory thrombophlebitis. It is generally attributed to a cancer-related hypercoagulable period, chronic dissemiated intravascular coagulopathy （DIC）, or tumor embolism. We reported a case of malignancy-releated thromboembolism from an undiagnosed pancreatic adenocarcinoma in a 54-year-old man, who presented with recurrent ischemic stroke due to chronic DIC. He died of the underlying malignancy despite the appropriate institution of anticoagulation therapy.This case emphasizes that cerebral infarction may be the first manifestation of an undiagnosed cancer. If there is laboratory or clinical evidence associated with DIC, patients with a cerebral infarct of an unknown etiology should be investigated for a malignant process. The optimal method of anticoagulation in cancer patients with thromboembolic disease （TED） remains unclear.展开更多
The trousseau’s sign is carpopedal spasm that results from ischemia that is induced by pressure applied to the upper arm. It is a sensitive and specific sign of hypocalcemia. Here the author is sending the short case...The trousseau’s sign is carpopedal spasm that results from ischemia that is induced by pressure applied to the upper arm. It is a sensitive and specific sign of hypocalcemia. Here the author is sending the short case summary, images of the demonstration of the Trousseau’s sign. This case also had a cluster of seizures induced by hypocalcemia.展开更多
Objective:rupture of liver metasta-ses with disturbance of consciousness accompanied by aggravation of hemiplegia is very rare.We describe the clinical features of a case of spontaneous rupture of liver metastasis tum...Objective:rupture of liver metasta-ses with disturbance of consciousness accompanied by aggravation of hemiplegia is very rare.We describe the clinical features of a case of spontaneous rupture of liver metastasis tumors with disturbance of consciousness and progression of right limb hemiplegia.Methods:collect the patient's medical history,conduct a detailed physi-cal examination,timely improve the relevant laboratory and imaging examination,formulate a comprehensive treatment plan,and track the changes of the disease and the treatment effect.Results:the patient presented with blurred consciousness,hemiplegia of the right limb,and epigastric tenderness when admitted to the hospital.No evident new lesions were found on cranial computed to-mography(CT).Blood routine examination showed that hemoglobin decreased significantly compared with be-fore.Abdominal CT showed tumor rupture and bleeding.The patient in critical condition did not have operation conditions,but improved after conservative treatment.Conclusion:when patients with liver metastasis tumors suddenly have a disturbance of consciousness and prog-ress of hemiplegia,they should not only be considered to have acute cerebrovascular diseases,but also the possi-bility of rupture of liver metastasis tumors.If only treated according to acute stroke,it will endanger their lives.For the liver metastasis tumor rupture,if there is no oppor-tunity for embolotherapy,timely conservative treatment with drugs can also achieve good results.展开更多
文摘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, cyto-kines, 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.
文摘In rare instances, stroke may preceed a diagnosis of cancer and be the first clinical evidence of an underlying malignancy.Cerebral infarction mostly complicates lymphomas, carcinomas, and solid tumors. Malignancy-related thromboembolism can present as acute cerebral infarction, nonbacterial thrombotic endocarditis and migratory thrombophlebitis. It is generally attributed to a cancer-related hypercoagulable period, chronic dissemiated intravascular coagulopathy （DIC）, or tumor embolism. We reported a case of malignancy-releated thromboembolism from an undiagnosed pancreatic adenocarcinoma in a 54-year-old man, who presented with recurrent ischemic stroke due to chronic DIC. He died of the underlying malignancy despite the appropriate institution of anticoagulation therapy.This case emphasizes that cerebral infarction may be the first manifestation of an undiagnosed cancer. If there is laboratory or clinical evidence associated with DIC, patients with a cerebral infarct of an unknown etiology should be investigated for a malignant process. The optimal method of anticoagulation in cancer patients with thromboembolic disease （TED） remains unclear.
文摘The trousseau’s sign is carpopedal spasm that results from ischemia that is induced by pressure applied to the upper arm. It is a sensitive and specific sign of hypocalcemia. Here the author is sending the short case summary, images of the demonstration of the Trousseau’s sign. This case also had a cluster of seizures induced by hypocalcemia.
基金Scientific Research Program of Hubei Provincial Department of Education in 2019(Q20192103).
文摘Objective:rupture of liver metasta-ses with disturbance of consciousness accompanied by aggravation of hemiplegia is very rare.We describe the clinical features of a case of spontaneous rupture of liver metastasis tumors with disturbance of consciousness and progression of right limb hemiplegia.Methods:collect the patient's medical history,conduct a detailed physi-cal examination,timely improve the relevant laboratory and imaging examination,formulate a comprehensive treatment plan,and track the changes of the disease and the treatment effect.Results:the patient presented with blurred consciousness,hemiplegia of the right limb,and epigastric tenderness when admitted to the hospital.No evident new lesions were found on cranial computed to-mography(CT).Blood routine examination showed that hemoglobin decreased significantly compared with be-fore.Abdominal CT showed tumor rupture and bleeding.The patient in critical condition did not have operation conditions,but improved after conservative treatment.Conclusion:when patients with liver metastasis tumors suddenly have a disturbance of consciousness and prog-ress of hemiplegia,they should not only be considered to have acute cerebrovascular diseases,but also the possi-bility of rupture of liver metastasis tumors.If only treated according to acute stroke,it will endanger their lives.For the liver metastasis tumor rupture,if there is no oppor-tunity for embolotherapy,timely conservative treatment with drugs can also achieve good results.
