DOCSLIB.ORG

Paraneoplastic Syndromes in Patients with Primary Malignancies of the Head and Neck

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Paraneoplastic Syndromes in Patients with Primary Malignancies of the Head and Neck Eur Arch Otorhinolaryngol (2006) 263: 32–36 DOI 10.1007/s00405-005-0942-1 HEAD AND NECK ONCOLOGY L. W. J. Baijens Æ J. J. Manni Paraneoplastic syndromes in patients with primary malignancies of the head and neck. Four cases and a review of the literature Received: 8 December 2004 / Accepted: 31 January 2005 / Published online: 29 June 2005 Ó Springer-Verlag 2005 Abstract Paraneoplastic syndromes rarely affect pa- patients [5, 13]. Often the paraneoplastic syndrome tients with head and neck cancer. Four patients with presents before the initial symptoms or diagnosis of the different histological types of head and neck cancer are primary malignancy or the recurrent tumour is made [5]. presented in which the primary malignancy was pre- Paraneoplastic syndromes occur in 1 to 7.4% of all ceded and/or accompanied by a paraneoplastic syn- cancer patients [7, 21]. The mechanisms of most para- drome. In the first patient erythrodermia preceded the neoplastic syndromes are not well known. Ectopic hor- diagnosis of a nasopharyngeal carcinoma. The second mone production is probably the most common patient presented with a B cell lymphoma of the mechanism [12]. Immunologic interactions in particular nasopharynx in association with the syndrome of inap- autoimmune responses play an important role in neu- propriate secretion of arginine vasopressine (Schwartz- rological paraneoplastic syndromes [1, 7, 10, 17]. In the Bartter syndrome). In the third patient paraneoplastic literature, paraneoplastic syndromes in association with polyarthritis had been diagnosed 5 months before a head and neck cancer have occasionally been reported. hypopharyngeal carcinoma was diagnosed. In the last Squamous cell carcinoma is the most common histopa- patient the paraneoplastic anti-Hu positive encephalo- thology of the primary malignancy of the head and neck myelitis was associated with a primary malignancy in the associated with paraneoplastic syndromes [12]. Also larynx with neck metastases. Diagnostic procedures, other histological types such as thyroid carcinoma, treatment and follow-up of these patients are reported lymphoma, thymoma, melanoma and paraganglioma of and accompanied by a review of the literature. the head and neck have been reported in association with paraneoplastic syndromes [12]. Ferlito et al. divided Keywords Paraneoplastic syndromes Æ Head and neck paraneoplastic syndromes associated with head and cancer Æ Squamous cell carcinoma Æ Anti-Hu neck cancer in four groups: paraneoplastic dermato- autoantibodies Æ Mucocutaneous lesions logical, endocrine, haematological and neurological syndromes [5]. In the literature more groups are reported such as rheumatological paraneoplastic syndromes [3, 4, 14, 18]. Many dermatological conditions have been de- Introduction scribed as paraneoplastic syndromes, also in head and neck cancer patients. Bazex syndrome is a frequently A paraneoplastic syndrome describes an association of reported paraneoplastic dermatological syndrome [5]. symptoms and signs not directly related to the site or Head and neck cancer has only occasionally been re- local manifestations of a malignant tumour or its ported in association with haematological and neuro- metastases and occurring in a minority of cancer logical syndromes [5]. In the literature cerebellar degeneration and the Eaton-Lambert myasthenia syn- drome are the most reported paraneoplastic neurologi- cal syndromes. They are seldom associated with laryngeal cancers. These neurological syndromes are L. W. J. Baijens (&) Æ J. J. Manni usually associated with small cell lung cancer [16, 17]. Department of Otorhinolaryngology Head and Neck Surgery, Serum and cerebrospinal fluid autoantibodies have re- Maastricht University Hospital, PO Box 5800, cently been identified for several neurological paraneo- 6202 AZ Maastricht, The Netherlands plastic syndromes [5, 16]. In this paper we report four E-mail: [email protected] different paraneoplastic syndromes associated with dif- Tel.: +31-433877580 Fax: +31-3875580 ferent primary tumours of the head and neck. 33 of recurrent epistaxis and neck nodes. During the ear, Case report nose and throat examination, a glue ear on the left side was observed. Nasendoscopy revealed a nasopharyngeal Case 1 tumour. Neck nodes were palpated in region II-III on the left side. Gradually she developed an abducens A 60-year-old woman was referred to the dermatological paralysis on the left side. On CT scan the paralysis could department of our university hospital in November 2002 be explained by tumour invasion of the sinus caverno- because of a therapy-resistant generalized erythematous sus. Biopsy of the nasopharynx tumour revealed a car- cutaneous eruption that had developed 2 months pre- cinoma. Fine-needle aspiration cytology (FNAC) of the viously. At first the skin of the trunk was affected, fol- neck nodes showed a squamous cell carcinoma. The lowed by progression towards the extremities, face and diagnosis of nasopharyngeal carcinoma with neck neck (Fig. 1). At the dermatological department, she metastasis and a dermatological paraneoplastic syn- was treated with a diversity of topical medication and drome was made. The tumour was classified as systemic antihistaminics without any effect. Several skin cT4N2M0. Radiotherapy was started in July 2003. In biopsies showed a non-specific chronic dermatitis. Skin 6 weeks a total dose of 70.2 Gy was given. During culture showed normal results. To exclude a paraneo- radiotherapy the skin rash and abducens paralysis dis- plastic syndrome the patient was referred to the appeared. Six months after radiotherapy the patient is departments of internal medicine and gynaecology for still in remission. extensive examination for a primary malignancy. Clini- cal examinations and imaging techniques showed nor- mal results. From that moment she was treated for late Case 2 onset constitutional eczema with cyclosporin and imip- ramine. Despite the medication the erythema persisted. A 71-year-old man visited our out-patient department in In April 2003 she was referred to our department of July 2003 because of bilateral hearing loss since several otorhinolaryngology and head and neck surgery because weeks without other complaints. He had never experi- enced otological problems in the past. He suffered from diabetes mellitus type II, which was treated with oral anti-diabetic medication. During routine ear, nose and throat examination glue ears were found bilaterally. The audiogram showed a bilateral mixed hearing loss with Fletcher index of 45 dB. The mean air bone gap was 25 dB. Endoscopy revealed a suspect lesion in the nasopharynx. Transtympanic ventilation tubes were placed, and nasopharyngeal biopsy was obtained. The diagnosis of a B cell non-Hodgkin lymphoma was made. CT scan showed an isolated nasopharyngeal lesion without intracerebral extension. The patient was re- ferred to the department of internal medicine for che- motherapy. Before the therapy was started, he developed a syndrome of inappropriate secretion of antidiuretic hormone (SIADH or Schwartz-Bartter syndrome) with weakness and lethargy and excessive blood levels of vasopressin in combination with hyponatremia, which was interpreted as a paraneoplastic syndrome. For the SIADH he was treated with restriction of fluid intake. Chemotherapy (cyclophosphamide, doxorubicin, vin- cristine, prednisolone: CHOP) was started in September 2003. The symptoms of SIADH as well as the primary tumour disappeared after chemotherapy. Five months after the initial treatment the patient is still in remission. Case 3 A 48-year-old man was referred to the department of rheumatology in November 1991 because of acute onset Fig. 1 Report number one: patient with a paraneoplastic derma- pain in several joints. The left knee, shoulders and the tological syndrome. Erythrodermia: generalized erythematous and first metatarsophalangeal joint on the left side were in- elevated cutaneous eruption with scaling and pruritus volved, soon followed by an inflammatory swelling of 34 the left knee. There were no rheumatoid nodules. Family October 2003 before radiotherapy of the supraglottic history of rheumatoid arthritis was negative. Blood tests malignancy was started. were negative for the Waaler-Rose test, complement factors III and IV and anti-nuclear factor. Skin and muscle biopsies showed normal tissue. CT Discussion scans of the thorax and abdomen and skeletal X-rays were normal. The diagnosis of an unclassified collagen The exact incidence of paraneoplastic syndromes in disease or vasculitis was made. The patient showed a association with head and neck cancer is not known. In very good response on treatment with a high dose of the literature paraneoplastic syndromes in association prednisone. Five months later he developed dysphagia with head and neck cancer are mostly described in case and dysphonia. He was referred to our department. A reports or review articles. In Table 1 the localisation and cT4N2cM0 hypopharynxcarcinoma was diagnosed. histological types of the paraneoplastic syndromes most A diagnosis of a paraneoplastic syndrome preceding a commonly associated with head and neck cancer are head and neck cancer was made. A laryngopharyngec- presented. Generally paraneoplastic syndromes are tomy with radical neck dissection on the right side and classified in four major groups as mentioned in the modified (functional) neck dissection on the left side was introduction. Three of the four patients fit in this classi- performed. During postoperative radiotherapy he fication. The fourth
Load more

Recommended publications
  • Electrolyte Disorders in Cancer Patients: a Systematic Review
    Berardi et al. J Cancer Metastasis Treat 2019;5:79 Journal of Cancer DOI: 10.20517/2394-4722.2019.008 Metastasis and Treatment Review Open Access Electrolyte disorders in cancer patients: a systematic review Rossana Berardi, Mariangela Torniai, Edoardo Lenci, Federica Pecci, Francesca Morgese, Silvia Rinaldi Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - GM Lancisi - G Salesi, Ancona 60126, Italy. Correspondence to: Prof. Rossana Berardi, Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero- Universitaria Ospedali Riuniti di Ancona, Via Conca 71, Ancona 60126, Italy. E-mail: [email protected] How to cite this article: Berardi R, Torniai M, Lenci E, Pecci F, Morgese F, Rinaldi S. Electrolyte disorders in cancer patients: a systematic review. J Cancer Metastasis Treat 2019;5:79. http://dx.doi.org/10.20517/2394-4722.2019.008 Received: 26 Apr 2019 First Decision: 26 Jul 2019 Revised: 20 Nov 2019 Accepted: 20 Nov 2019 Published: 9 Dec 2019 Science Editor: Stephen J. Ralph Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu Abstract Electrolyte disorders are very common complications in cancer patients. They might be associated to a worsening outcome, influencing quality of life, possibility to receive anticancer drugs, and conditioning survival. In fact, they might provoke important morbidity, with dysfunction of multiple organs and rarely causing life-threatening conditions. Moreover, recent studies showed that they might worsen cancer patients’ outcome, while a prompt correction seems to have a positive impact. Furthermore, there is evidence of a correlation between electrolyte alterations and poorer performance status, delays in therapy commencement and continuation, and negative treatment outcomes.
    [Show full text]
  • Paraneoplastic Encephalomyelitis: Is It an Oropharyngeal Or a Lung Cancer Complication?
    ONCOLOGY LETTERS 2: 171-174, 2011 Paraneoplastic encephalomyelitis: Is it an oropharyngeal or a lung cancer complication? MARÍA SERENO Moyano1, GERARDO GUTIÉRREZ-GUTIÉRREZ2, CÉSAR GÓMEZ-RAPOSO1, MIRIAM LÓPEZ GÓMEZ1, JOAQUÍN OJEDA2, AmBroSio mirAlleS2 and ENRIQUE CASADO-SÁENZ1 Departments of 1Oncology, and 2Neurology, Infanta Sofía Hospital, San Sebastián de los Reyes, Madrid, Spain Received September 30, 2010; Accepted November 12, 2010 DOI: 10.3892/ol.2010.224 Abstract. This case report describes a patient with a locally tumor and the nervous system suggests that these disorders advanced oropharyngeal cancer with a simultaneous para- are immune-mediated. Numerous onconeural antibodies have neoplastic encephalomyelitis. To the best of our knowledge, a been described, but less than 50% of patients with PNS harbor paraneoplastic neurological syndrome is a rare complication these types of proteins. in head and neck cancer, and has previously not been reported Therefore, the absence of paraneoplastic antibodies in the literature. One year later, following initial treatment, does not exclude the diagnosis of PNS. The main neuro- a small cell lung cancer developed, a tumor frequently logical syndromes associated with paraneoplastic origin associated with this type of paraneoplastic syndrome. The include limbic encephalitis, subacute cerebellar ataxia, dilemma, therefore, is whether this paraneoplastic symdrome opsoclonus-myoclonus, retinopathies, chronic gastrointestinal was a secondary complication of the tonsilar concurrent cancer pseudoobstruction, sensory neuronopathy, Lambert-Eaton or a metachronous paraneoplastic syndrome prior to small myasthenic syndrome and encephalomyelitis (3). cell lung cancer. The majority of tumors associated with PNS are small cell lung cancer (SCLC), ovarian cancer and hematological Introduction diseases, mainly lymphomas. PNS in HNC is extremely rare.
    [Show full text]
  • PARANEOPLASTIC SYNDROMES: J Neurol Neurosurg Psychiatry: First Published As 10.1136/Jnnp.2004.040378 on 14 May 2004
    PARANEOPLASTIC SYNDROMES: J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.2004.040378 on 14 May 2004. Downloaded from WHEN TO SUSPECT, HOW TO CONFIRM, AND HOW TO MANAGE ii43 J H Rees J Neurol Neurosurg Psychiatry 2004;75(Suppl II):ii43–ii50. doi: 10.1136/jnnp.2004.040378 eurological manifestations of cancer are common, disabling, and often multifactorial (table 1). The concept that malignant disease can cause damage to the nervous system Nabove and beyond that caused by direct or metastatic infiltration is familiar to all clinicians looking after cancer patients. These ‘‘remote effects’’ or paraneoplastic manifestations of cancer include metabolic and endocrine syndromes such as hypercalcaemia, and the syndrome of inappropriate ADH (antidiuretic hormone) secretion. Paraneoplastic neurological disorders (PNDs) are remote effects of systemic malignancies that affect the nervous system. The term PND is reserved for those disorders that are caused by an autoimmune response directed against antigens common to the tumour and nerve cells. PNDs are much less common than direct, metastatic, and treatment related complications of cancer, but are nevertheless important because they cause severe neurological morbidity and mortality and frequently present to the neurologist in a patient without a known malignancy. Because of the relative rarity of PND, neurological dysfunction should only be regarded as paraneoplastic if a particular neoplasm associates with a remote but specific effect on the nervous system more frequently than would be expected by chance. For example, subacute cerebellar ataxia in the setting of ovarian cancer is sufficiently characteristic to be called paraneoplastic cerebellar degeneration, as long as other causes have been ruled out.
    [Show full text]
  • Fgf8b Oncogene Mediates Proliferation and Invasion of Epstein–Barr Virus-Associated Nasopharyngeal Carcinoma Cells: Implication for Viral-Mediated Fgf8b Upregulation
    Oncogene (2011) 30, 1518–1530 & 2011 Macmillan Publishers Limited All rights reserved 0950-9232/11 www.nature.com/onc ORIGINAL ARTICLE FGF8b oncogene mediates proliferation and invasion of Epstein–Barr virus-associated nasopharyngeal carcinoma cells: implication for viral-mediated FGF8b upregulation VWY Lui1,7, DM-S Yau1,7, CS-F Cheung1, SCC Wong1, AK-C Chan2, Q Zhou1, EY-L Wong1, CPY Lau1, EKY Lam1, EP Hui1, B Hong1, CWC Hui1, AS-K Chan1, PKS Ng3, Y-K Ng4, K-W Lo5, CM Tsang6, SKW Tsui3, S-W Tsao6 and ATC Chan1 1State Key Laboratory of Oncology in South China, Sir YK Pao Center for Cancer, Department of Clinical Oncology, Chinese University of Hong Kong, Hong Kong; 2Department of Pathology, Queen Elizabeth Hospital, Hong Kong; 3School of Biomedical Sciences, Chinese University of Hong Kong, Hong Kong; 4Department of Surgery, Chinese University of Hong Kong, Hong Kong; 5Department of Anatomical and Cellular Pathology, Chinese University of Hong Kong, Hong Kong and 6Department of Anatomy, University of Hong Kong, Hong Kong The fibroblast growth factor 8b (FGF8b) oncogene is identified LMP1 as the first viral oncogene capable of known to be primarily involved in the tumorigenesis and directly inducing FGF8b (an important cellular oncogene) progression of hormone-related cancers. Its role in other expression in human cancer cells. This novel mechanism of epithelial cancers has not been investigated, except for viral-mediated FGF8 upregulation may implicate a new esophageal cancer, in which FGF8b overexpression was role of oncoviruses in human carcinogenesis. mainly found in tumor biopsies of male patients. These Oncogene (2011) 30, 1518–1530; doi:10.1038/onc.2010.529; observations were consistent with previous findings in published online 29 November 2010 these cancer types that the male sex-hormone androgen is responsible for FGF8b expression.
    [Show full text]
  • Short-Term E Cacy Comparison Between Helical Tomotherapy and Intensity-Modulated Radiotherapy in Patients with Locally Advanced
    Short-term ecacy comparison between helical tomotherapy and intensity-modulated radiotherapy in patients with locally advanced nasopharyngeal carcinoma Zhen Cui ( [email protected] ) Aliated Hospital of Bengbu Medical College Jia Liu Aliated Hospital of Bengbu Medical College Qiaoyu Sun Aliated hospital of Bengbu medical college Chaoge Wang Aliated Hospital of Bengbu Medical College Meifang Fang Aliated Hospital of Bengbu Medical College Zelai He Aliated Hospital of Bengbu Medical College Duojie Li Aliated Hospital of Bengbu Medical College Hao Jiang Aliated Hospital of Bengbu Medical College Research article Keywords: Nasopharyngeal carcinoma, helical tomotherapy, intensity-modulated radiotherapy, Dosimetry analysis, Adverse events Posted Date: April 9th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-21288/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Abstract Background: To evaluate short-term safety and ecacy of helical tomotherapy (HT) versus intensity- modulated radiotherapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). Methods: Retrospective analysis of locally advanced nasopharyngeal carcinoma treated with radiotherapy and concurrent platinum based neoadjuvant chemotherapy (cisplatin 80 mg/m2 every 3 weeks for 1 cycle) in our hospital from February 2017 to October 2019, including 70 patients in HT group and 70 in IMRT group. The target area of the tumor was delineated by magnetic resonance (MRI) imaging. The prescription doses delivered to the gross tumor volume (pGTVnx) and positive lymph nodes (pGTVnd), the high risk planning target volume (PTV1), and the low risk planning target volume (PTV2), were 69.96 Gy, 66-70 Gy, 60 Gy and 50-54 Gy, in 33 fractions, respectively.
    [Show full text]
  • A Potential Respiratory Syncytial Virus (RSV) Infection
    Respiratory Syncytial Virus (RSV) Infection Induces Cyclooxygenase 2: A Potential Target for RSV Therapy This information is current as Joann Y. Richardson, Martin G. Ottolini, Lioubov Pletneva, of September 27, 2021. Marina Boukhvalova, Shuling Zhang, Stefanie N. Vogel, Gregory A. Prince and Jorge C. G. Blanco J Immunol 2005; 174:4356-4364; ; doi: 10.4049/jimmunol.174.7.4356 http://www.jimmunol.org/content/174/7/4356 Downloaded from References This article cites 70 articles, 27 of which you can access for free at: http://www.jimmunol.org/content/174/7/4356.full#ref-list-1 http://www.jimmunol.org/ Why The JI? Submit online. • Rapid Reviews! 30 days* from submission to initial decision • No Triage! Every submission reviewed by practicing scientists • Fast Publication! 4 weeks from acceptance to publication by guest on September 27, 2021 *average Subscription Information about subscribing to The Journal of Immunology is online at: http://jimmunol.org/subscription Permissions Submit copyright permission requests at: http://www.aai.org/About/Publications/JI/copyright.html Email Alerts Receive free email-alerts when new articles cite this article. Sign up at: http://jimmunol.org/alerts The Journal of Immunology is published twice each month by The American Association of Immunologists, Inc., 1451 Rockville Pike, Suite 650, Rockville, MD 20852 Copyright © 2005 by The American Association of Immunologists All rights reserved. Print ISSN: 0022-1767 Online ISSN: 1550-6606. The Journal of Immunology Respiratory Syncytial Virus (RSV) Infection Induces Cyclooxygenase 2: A Potential Target for RSV Therapy1 Joann Y. Richardson,* Martin G. Ottolini,* Lioubov Pletneva,§ Marina Boukhvalova,§ Shuling Zhang,† Stefanie N.
    [Show full text]
  • Primary Nasopharyngeal Kaposi Sarcoma As Index Diagnosis of AIDS in a Previously Healthy Man
    Head and Neck Pathology (2019) 13:664–667 https://doi.org/10.1007/s12105-018-0954-y SINE QUA NON CLINICOPATHOLOGIC CORRELATION Primary Nasopharyngeal Kaposi Sarcoma as Index Diagnosis of AIDS in a Previously Healthy Man Gwyneth S. T. Soon1 · Fredrik Petersson1 · Mark K. T. Thong2 · Char Loo Tan1,3 Received: 12 July 2018 / Accepted: 18 July 2018 / Published online: 23 July 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract A 38-year-old, previously healthy man presented with blood-stained saliva and epistaxis. A 3 mm nasopharyngeal lesion was found. A biopsy was performed and microscopic examination revealed a Kaposi sarcoma. The patient was subsequently found to be positive for human immunodeficiency virus (HIV). The diagnosis of Kaposi sarcoma in the presence of HIV infection advanced his disease to Acquired Immunodeficiency Syndrome (AIDS). Primary manifestation of Kaposi sarcoma in the nasopharynx is extremely rare. The histologic differential diagnosis of Kaposi sarcoma in this unusual site, especially without the clinical history of immunosuppression, is broad. Awareness that nasopharynx can be a primary involvement site of Kaposi sarcoma and serves as index diagnosis of AIDS is important given its serious clinical implication. Keywords Kaposi sarcoma · Nasopharynx · Nasal cavity · AIDS · HIV · HHV8 History Diagnosis A 38-year-old Asian male with no significant medical his- Histology of the left postnasal space mass biopsy showed tory presented with episodes of blood-stained saliva and pieces of upper respiratory tract-type mucosa with a cellu- epistaxis, associated with bilateral cervical swelling of 1–2 lar tumor in the subepithelial stroma, composed of fascicles months’ duration.
    [Show full text]
  • CD4‑Positive Lymphoepithelial‑Like Carcinoma: Report of Unusual Case
    Published online: 2021-08-12 CASE REPORT CD4‑positive lymphoepithelial‑like carcinoma: Report of unusual case Luaay Aziz, Raya Saab1, Toufic Eid2, Mousa A. Al‑Abbadi3 Department of Ent and Head and Neck Surgery, Healthpoint Hospital, Abu Dhabi, United Arab Emirates, Departments of 1Pediatrics and Adolescent Medicine and 2Radiation Oncology, American University of Beirut, Beirut, Lebanon, 3Department of Pathology and Laboratory Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates Access this article online ABSTRACT Website: www.avicennajmed.com DOI: 10.4103/ajm.AJM_135_17 We are reporting an unusual case of lymphoepithelial‑like carcinoma (LELC) in an 8‑year‑old Quick Response Code: female patient where the tumor cells showed unusual CD4 expression. The lesion was found in the left submandibular neck region, in the vicinity of the submandibular gland. The salivary gland was not infiltrated by the tumor, and the tumor exhibited a classic LELC with single and clusters of tumor cells surrounded by many hematolymphoid cells. The tumor cells revealed strong positivity for Epstein–Bar virus as confirmed by the EBER: Epstein‑Barr Virus in situ hybridization (EBER‑ISH) method of staining. Interestingly, the tumor cells expressed membranous immunostaining for the T‑helper lymphocyte antibody (CD4) in addition to pan‑cytokeratin. A brief discussion about this unusual finding is offered. The patient was treated as a case of Epstein–Bar virus‑associated nasopharyngeal carcinoma with excellent response. Key words: CD4, Epstein–Bar virus, lymphoepithelial‑like carcinoma, nasopharyngeal carcinoma INTRODUCTION After obtaining the appropriate internal review board approvals and patient family consent, we present extremely Masses and swelling in the head and neck are common unusual case of lymph node enlargement in the left side presentation in children as well as adults.
    [Show full text]
  • Paraneoplastic Syndromes in Lung Cancer and Their Management
    359 Review Article Page 1 of 9 Paraneoplastic syndromes in lung cancer and their management Asad Anwar1, Firas Jafri1, Sara Ashraf2, Mohammad Ali S. Jafri3, Michael Fanucchi3 1Department of Internal Medicine, Westchester Medical Center, Valhalla, NY, USA; 2Department of Hematology/Oncology, Marshall University, Huntington, WV, USA; 3Department of Hematology/Oncology, Westchester Medical Center, Valhalla, NY, USA Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Mohammad Ali S. Jafri, MD. Department of Hematology/Oncology, Westchester Medical Center, Valhalla, NY, USA. Email: [email protected]. Abstract: Paraneoplastic syndromes are most frequently associated with lung cancer. This review considers a variety paraneoplastic syndromes associated with lung cancer and discusses their pathophysiology, clinical features and management options. Keywords: Paraneoplastic syndromes; lung cancer; thoracic oncology Submitted Feb 12, 2019. Accepted for publication Apr 25, 2019. doi: 10.21037/atm.2019.04.86 View this article at: http://dx.doi.org/10.21037/atm.2019.04.86 Introduction PTHrP production (parathyroid hormone related-protein), it is referred to as HHM. Paraneoplastic syndromes refer to the remote effects HHM is observed in a variety of malignancies such as associated with malignancy which are unrelated to direct breast, renal, multiple myeloma and lung; squamous cell tumor invasion or metastases (1). These may occur before is the most frequently observed subtype (3-5). Osteolytic the cancer is diagnosed and can be independent in their metastases are another significant cause of hypercalcemia in severity to the stage of the primary tumor.
    [Show full text]
  • Oral Diseases Associated with Human Herpes Viruses: Aetiology, Clinical Features, Diagnosis and Management
    www.sada.co.za / SADJ Vol 71 No. 6 CLINICAL REVIEW < 253 Oral diseases associated with human herpes viruses: aetiology, clinical features, diagnosis and management SADJ July 2016, Vol 71 no 6 p253 - p259 R Ballyram1, NH Wood2, RAG Khammissa3, J Lemmer4, L Feller5 ABSTRACT Human herpesviruses (HHVs) are very prevalent DNA ACRONYMS viruses that can cause a variety of orofacial diseases. EM: erythema multiforme Typically they are highly infectious, are contracted early in HHV: human herpes virus life, and following primary infection, usually persist in a latent form. Primary oral infections are often subclinical, but may PCR: polymerase chain reaction be symptomatic as in the case of herpes simplex virus- HSV, HHV-1: herpes simplex virus induced primary herpetic gingivostomatitis. Reactivation VZV, HHV-3: varicella-zoster virus of the latent forms may result in various conditions: herpes EBV, HHV-4: Epstein-Barr virus simplex virus (HSV) can cause recurrent herpetic orolabial CMV, HHV-5: cytomegalovirus lesions; varicella zoster virus (VZV) can cause herpes zoster; Epstein-Barr virus (EBV) can cause oral hairy Key words: herpes simplex virus, human herpes virus-8, leukoplakia; and reactivation of HHV-8 can cause Kaposi varicella zoster virus, Epstein-Barr virus, recurrent herpes sarcoma. In immunocompromised subjects, infections labialis, recurrent intraoral herpetic ulcers, treatment, val- with human herpesviruses are more extensive and aciclovir, aciclovir, famcicylovir. severe than in immunocompetent subjects. HSV and VZV infections are treated with nucleoside analogues aciclovir, valaciclovir, famciclovir and penciclovir. These agents INTRODucTION have few side effects and are effective when started The human herpesvirus (HHV) family comprises a diverse early in the course of the disease.
    [Show full text]
  • Cancer Patients Have a Higher Risk Regarding COVID-19–And Vice Versa?
    pharmaceuticals Opinion Cancer Patients Have a Higher Risk Regarding COVID-19–and Vice Versa? Franz Geisslinger, Angelika M. Vollmar and Karin Bartel * Pharmaceutical Biology, Department Pharmacy, Ludwig-Maximilians-University of Munich, 81377 Munich, Germany; [email protected] (F.G.); [email protected] (A.M.V.) * Correspondence: [email protected] Received: 29 May 2020; Accepted: 3 July 2020; Published: 6 July 2020 Abstract: The world is currently suffering from a pandemic which has claimed the lives of over 230,000 people to date. The responsible virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and causes the coronavirus disease 2019 (COVID-19), which is mainly characterized by fever, cough and shortness of breath. In severe cases, the disease can lead to respiratory distress syndrome and septic shock, which are mostly fatal for the patient. The severity of disease progression was hypothesized to be related to an overshooting immune response and was correlated with age and comorbidities, including cancer. A lot of research has lately been focused on the pathogenesis and acute consequences of COVID-19. However, the possibility of long-term consequences caused by viral infections which has been shown for other viruses are not to be neglected. In this regard, this opinion discusses the interplay of SARS-CoV-2 infection and cancer with special focus on the inflammatory immune response and tissue damage caused by infection. We summarize the available literature on COVID-19 suggesting an increased risk for severe disease progression in cancer patients, and we discuss the possibility that SARS-CoV-2 could contribute to cancer development.
    [Show full text]
  • Influence of Epstein–Barr Virus and Human Papillomavirus Infection On
    Feng et al. BMC Cancer (2021) 21:929 https://doi.org/10.1186/s12885-021-08675-x RESEARCH Open Access Influence of Epstein–Barr virus and human papillomavirus infection on macrophage migration inhibitory factor and macrophage polarization in nasopharyngeal carcinoma Guofei Feng1,2†, Yifei Xu1,2,3†, Ning Ma4, Kaoru Midorikawa1, Shinji Oikawa1, Hatasu Kobayashi1, Satoshi Nakamura2, Hajime Ishinaga2, Zhe Zhang3, Guangwu Huang5, Kazuhiko Takeuchi2* and Mariko Murata1* Abstract Background: To assess the effects of Epstein–Barr virus (EBV) and human papillomavirus (HPV) infection on the tumor microenvironment, we examined the relationship between viral infection status, macrophage migration inhibitory factor (MIF), and tumor-associated macrophages in nasopharyngeal carcinoma (NPC). Methods: A tissue microarray containing 150 cores from 90 patients with NPC and six with chronic inflammation was used. EBV and HPV status were detected using in situ hybridization with commercial EBER1 and HPV16/18 probes. Immunofluorescence double staining of MIF, pan-macrophage marker CD68, M1 macrophage marker CD11c, and M2 macrophage marker CD163 were analyzed using the same tissue microarray. The levels of these markers between NPC and inflammation cases and between tumor nests and stroma were compared. Correlations among these markers were analyzed. Results: We found EBER1(+) cases in 90% of NPC patients, including 10% EBV/HPV co-infection. M1 macrophages mainly infiltrated the tumor nest, while M2 macrophages infiltrated the tumor stroma. We found a significant positive correlation between EBER1 levels and MIF levels in tumor nests and a significant positive correlation between HPV16/18 and CD11c(+) cell levels in NPC tissues. Conclusions: It is suggested that MIF is associated with EBV, and M1 macrophage infiltration is affected by HPV status in NPC.
    [Show full text]