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Paraneoplastic endocrine syndromes

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Dimitriadis, Georgios K., Angelousi, Anna, Weickert, Martin O., Randeva, Harpal S., Kaltsas, Gregory and Grossman, Ashley (2017) Paraneoplastic endocrine syndromes. Endocrine-Related Cancer, 24 (6). R173-R190. doi:10.1530/ERC-17-0036 ISSN 1351-0088.

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Official URL: http://dx.doi.org/10.1530/ERC-17-0036

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Abstract

The majority of neoplasms are responsible for symptoms caused by mass effects to surrounding tissues and/or through the development of metastases. However, occasionally neoplasms, with or without endocrine differentiation, acquire the ability to secrete a variety of bioactive substances or induce immune cross-reactivity with the normal tissues that can lead to the development of characteristic clinical syndromes. These syndromes are named endocrine paraneoplastic syndromes when the specific secretory components (hormones, peptides or cytokines) are unrelated to the anticipated tissue or organ of origin. Endocrine paraneoplastic syndromes can complicate the patient’s clinical course, response to treatment, impact prognosis and even be confused as metastatic spread. These syndromes can precede, occur concomitantly or present at a later stage of tumour development, and along with the secreted substances constitute the biological ‘fingerprint’ of the tumour. Their detection can facilitate early diagnosis of the underlying neoplasia, monitor response to treatment and/or detect early recurrences following successful initial management. Although when associated with tumours of low malignant potential they usually do not affect long-term outcome, in cases of highly malignant tumours, endocrine paraneoplastic syndromes are usually associated with poorer survival outcomes. Recent medical advances have not only improved our understanding of paraneoplastic syndrome pathogenesis in general but also enhanced their diagnosis and treatment. Yet, given the rarity of endocrine paraneoplastic syndromes, there is a paucity of prospective clinical trials to guide management. The development of well-designed prospective multicentre trials remains a priority in the field in order to fully characterise these syndromes and provide evidence-based diagnostic and therapeutic protocols.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Endocrine-Related Cancer
Publisher: BioScientifica
ISSN: 1351-0088
Official Date: 1 June 2017
Dates:
DateEvent
1 June 2017Published
24 March 2017Accepted
Volume: 24
Number: 6
Page Range: R173-R190
DOI: 10.1530/ERC-17-0036
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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