Small cell carcinoma of the lung history and symptoms: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(25 intermediate revisions by 6 users not shown)
Line 2: Line 2:
{{Small cell carcinoma of the lung}}
{{Small cell carcinoma of the lung}}


{{CMG}} '''Associate Editor(s)-In-Chief:''' {{GRN}}
{{CMG}}; {{AE}} {{GRN}}; {{Rim}}


==Overview==
==Overview==
Small cell lung cancer comprises 15% to 25% of bronchogenic carcinomas and it is the cancer most commnoly associated with a plethora of [[paraneoplastic syndromes]].<ref name="pmid18316005">{{cite journal| author=Sher T, Dy GK, Adjei AA| title=Small cell lung cancer. | journal=Mayo Clin Proc | year= 2008 | volume= 83 | issue= 3 | pages= 355-67 | pmid=18316005 | doi=10.4065/83.3.355 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18316005  }} </ref> It usually develops in the upper airways and involves the [[hilum]] and [[mediastinum]]. Most of the times, evidence of regional or distant [[metastases]] is found at the time patients present with small cell lung carcinoma. <ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
Small cell lung cancer (SCLC) is characterized by a relatively rapid onset of [[Symptom|symptoms]]. [[Patient|Patients]] usually present within 8 to 12 weeks of the onset of [[Symptom|symptoms]], which can be related either to the tumor growth in the [[thorax]] or to the distant spread of the [[tumor]]. In addition, SCLC is associated with the occurrence of [[paraneoplastic syndrome]]s such as the [[syndrome of inappropriate antidiuresis]] ([[SIADH]]).


==History and Symptoms==
==History and Symptoms==
*Patients are typically men older than 70 years,  heavy current or ex-smokers and have a lot of pulmonary, cardiovascular, and metabolic comorbidities.
===History===
* SCLC is characterized by a relatively rapid onset of [[Symptom|symptoms]]. 
*[[Patient|Patients]] with SCLC usually present within 8 to 12 weeks of the onset of [[Symptom|symptoms]].
*A typical SCLC [[patient]] is a 70 year old male who is either a [[Smoking|smoker]] or an ex-smoker.<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
* A full medical history should be obtained. 
*Information should be obtained regarding:
**[[Tobacco smoking]] status
**[[Family history]] of [[lung cancer]]


*Early small cell carcinoma of the lung does not have any symptoms. Initial presenting symptoms may be airway related, but are often constitutional and attributable to metastases:<ref name="pmid2181676">{{cite journal| author=Grippi MA| title=Clinical aspects of lung cancer. | journal=Semin Roentgenol | year= 1990 | volume= 25 | issue= 1 | pages= 12-24 | pmid=2181676 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2181676 }} </ref><ref name="pmid4813837">{{cite journal| author=Hyde L, Hyde CI| title=Clinical manifestations of lung cancer. | journal=Chest | year= 1974 | volume= 65 | issue= 3 | pages= 299-306 | pmid=4813837 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4813837 }} </ref>  
===Symptoms Related to Tumor Growth in the Thorax===
* [[Cough]] (most common [[symptom]])<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref><ref name="pmid12527569">{{cite journal| author=Beckles MA, Spiro SG, Colice GL, Rudd RM| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes. | journal=Chest | year= 2003 | volume= 123 | issue= 1 Suppl | pages= 97S-104S | pmid=12527569 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12527569  }} </ref>
* [[Wheezing]]<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
* [[Dyspnea|Difficulty breathing]]<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397 }} </ref>
* [[Hemoptysis|Bloody cough]]<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
* [[Chest pain]]<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397 }} </ref>


:::*[[Cough]] 75%
===Constitutional Symptoms===
:::*[[Weight loss]] 68%
* [[Fatigue]]
:::*[[Dyspnea]] 60%
* [[Anorexia]]
:::*[[Chest pain]] 49%
* [[Weight loss]]
:::*[[Hemoptysis]] 35%
* [[Low grade fever]]
:::*[[Bone pain]] 25%
:::*[[Clubbing]] 20%
:::*[[Fever]] 20%
:::*[[hoarseness]] 18%
:::*[[Weakness]] 10%
:::*[[Superior vena cava syndrome]] 4%
:::*[[Dysphagia]] 2%
:::*New onset of [[wheezing]] and [[stridor]] 2%


*[[Cough]], [[dyspnea]], [[chest pain]], and [[hemoptysis]] most commonly are related to the primary tumor.<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166 }} </ref>
===Symptoms Related to Paraneoplastic Syndromes===
* [[Syndrome of inappropriate antidiuresis|Syndrome of inappropriate antidiuresis (SIADH)]] (frequency: 15 - 40%):<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
**[[Weakness]]
*[[Hypercalcemia]] (frequency: 8 - 12%):<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
**[[Nausea]]
**[[Vomiting]]
**[[Abdominal pain]]
**[[Constipation]]
**[[Polyuria]]
**[[Thirst]]
**[[Dehydration]]
**[[Confusion]]
**[[Irritability]]
*[[Cushing's syndrome]] (frequency: 2 - 5%):<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
**Rapid [[obesity|weight gain]], particularly of the trunk and face with sparing of the limbs ([[central obesity]])
**A round face often referred to as a "[[moon face]]"
**Excessive [[sweating]]
**[[Insomnia]]
**Reduced [[libido]]
**[[Amenorrhoea]]
*[[Lambert-Eaton syndrome]] (frequency: 3%):<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
**[[Weakness]] of the proximal muscles of lower extremities
**Abnormal [[gait]]
**[[Autonomic dysfunction]]
**[[Paresthesia]]
*[[Limbic encephalitis]] and [[encephalomyelitis]] (frequency < 1%):<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
**[[Altered mental status]]
**[[Seizures]]
**[[Memory loss]]
**Space and time [[disorientation]] with or without [[dementia]]
*[[Paraneoplastic cerebellar degeneration]] (frequency < 1%):<ref name="pmid21565397">{{cite journal| author=van Meerbeeck JP, Fennell DA, De Ruysscher DK| title=Small-cell lung cancer. | journal=Lancet | year= 2011 | volume= 378 | issue= 9804 | pages= 1741-55 | pmid=21565397 | doi=10.1016/S0140-6736(11)60165-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21565397  }} </ref>
**[[Ataxia]]
**[[Dysarthria]]
**Severe [[vertigo]]
*[[Amenorrhea]]  (due to production of [[prolactin]] or [[growth hormone]])<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730  }} </ref>
*[[Galactorrhea]]  (due to production of [[prolactin]] or [[growth hormone]])<ref name="pmid16813730">{{cite journal| author=Gandhi L, Johnson BE| title=Paraneoplastic syndromes associated with small cell lung cancer. | journal=J Natl Compr Canc Netw | year= 2006 | volume= 4 | issue= 6 | pages= 631-8 | pmid=16813730 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16813730 }} </ref>


*The intrathoracic spread of lung cancer produces a variety of symptoms such as [[hoarseness]] due to recurrent laryngeal nerve palsy; pain, cutaneous temperature change, and muscle wasting along the C8, T1 and T2 nerve roots (Pancoast syndrome); [[Horner syndrome]]: miosis, ipsilateral ptosis and lack of facial sweating; dysphagia due to enlargement of the [[subcarinal lymph nodes]] and compression of the middle third of the [[esophagus]].<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
===Symptoms Related to the Distant Spread of the Tumor===
* [[Hoarseness]] (involvement of the [[recurrent laryngeal nerve]])<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Dyspnea]] (one of the causes is the involvement of the [[phrenic nerve]] and subsequent elevation of the hemi-[[diaphragm]])<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Pain]], [[muscle wasting]], or change in the skin temperature in areas corresponding to cervical spinal nerve C8 or [[thoracic nerve]] T2 to T4 (involvement of the [[brachial plexus]])<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Chest pain]] (one of the causes is the involvement of the chest wall)<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Pleuritic chest pain]]<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Horner syndrome]] manifested by unilateral [[miosis]], [[ptosis]] and anhydrosis (involvement of the sympathetic trunk)<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Arrhythmia]] (involvement of the [[pericardium]])<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Cardiac tamponade]] manifested by chest pain, [[altered mental status]], [[cold extremities]], peripheral [[cyanosis]] (involvement of the [[pericardium]])<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Dysphagia]] (compression of the [[esophagus]])<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* [[Superior vena cava syndrome]] manifested by [[dyspnea]], [[headache]], and [[swelling]] of the face, neck, trunk, and arms<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166  }} </ref>
* Localized [[bone pain]] most commonly on the axial skeleton and proximal long bones (suggestive of bone [[metastasis]])
*[[Jaundice]] (suggestive of liver metastasis)
*[[Headache]], [[nausea]] and [[vomiting]], focal neurologic symptoms, [[seizures]], [[confusion]], and personality changes (suggestive of [[brain]] metastasis)
*Palpable masses, particularly in the supraclavicular area (suggestive of [[lymphadenopathy]])


*The pericardium is the most common site of cardiac involvement, which can cause [[pericardial effusion]] or [[supraventricular arrhythmias]].<ref name="pmid4546955">{{cite journal| author=Onuigbo WI| title=The spread of lung cancer to the heart, pericardium and great vessels. | journal=Jpn Heart J | year= 1974 | volume= 15 | issue= 3 | pages= 234-8 | pmid=4546955 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4546955  }} </ref>
===Uncommon Symptoms===
 
* [[Abdominal discomfort]] due to bilateral adrenal mass<ref name="pmid23825789">{{cite journal| author=Singh N, Madan K, Aggarwal AN, Das A| title=Symptomatic large bilateral adrenal metastases at presentation in small-cell lung cancer: a case report and review of the literature. | journal=J Thorac Dis | year= 2013 | volume= 5 | issue= 3 | pages= E83-6 | pmid=23825789 | doi=10.3978/j.issn.2072-1439.2011.09.05 | pmc=PMC3698258 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23825789 }} </ref>
*Common sites of metastasis include bone, [[liver]], [[lymph node]], the [[central nervous system]], [[adrenal glands]], [[subcutaneous tissue]] and [[pleura]].<ref name="pmid17873166">{{cite journal| author=Spiro SG, Gould MK, Colice GL, American College of Chest Physicians| title=Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). | journal=Chest | year= 2007 | volume= 132 | issue= 3 Suppl | pages= 149S-160S | pmid=17873166 | doi=10.1378/chest.07-1358 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17873166 }} </ref>
* [[Facial nerve palsy]] due to [[metastasis]] to the [[facial nerve]]<ref name="pmid21526004">{{cite journal| author=Yildiz O, Buyuktas D, Ekiz E, Selcukbiricik F, Papila I, Papila C| title=Facial nerve palsy: an unusual presenting feature of small cell lung cancer. | journal=Case Rep Oncol | year= 2011 | volume= 4 | issue= 1 | pages= 35-8 | pmid=21526004 | doi=10.1159/000324182 | pmc=PMC3082487 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21526004 }} </ref>
:::*[[Bone]]: most commonly axial skeleton and proximal long bones, which causes [[pain]].
:::*[[Liver]]: can cause [[jaundice]], [[weakness]] and [[weight loss]].
:::*[[Adrenal glands]]: very common with SCLC, although evidence of adrenal insufficiency is uncommon.
:::*[[Central nervous system]]: may produce [[headache]], [[nausea]] and [[vomiting]], focal neurologic symptoms, [[seizures]], [[confusion]], and personality changes.
:::*[[Lymph nodes]]: being the [[supraclavicular fossa]] the most common site of palpable [[lymphadenopathy]]
 
*SCLC is the most frequent cause of paraneoplastic syndromes, being the [[syndrome of inappropriate antidiuresis]] and [[cushing's syndrome]] the most common.<ref name="pmid17507705">{{cite journal| author=Ellison DH, Berl T| title=Clinical practice. The syndrome of inappropriate antidiuresis. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 20 | pages= 2064-72 | pmid=17507705 | doi=10.1056/NEJMcp066837 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17507705 }} </ref><ref name="pmid19734443">{{cite journal| author=Boscaro M, Arnaldi G| title=Approach to the patient with possible Cushing's syndrome. | journal=J Clin Endocrinol Metab | year= 2009 | volume= 94 | issue= 9 | pages= 3121-31 | pmid=19734443 | doi=10.1210/jc.2009-0612 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19734443  }} </ref>
 
{| border="1" cellpandding=2"
|-valign="top"
|width="20%"|'''[[Superior vena cava syndrome]]'''
|width="70%"|[[Edema]] of upper body, visible dilated veins over the upper torso, shoulders and arms, [[headache]], [[dizziness]], [[drowsiness]], [[blurring of vision]], [[cough]], [[dysphagia]]
|width="10%"|Frequency: 50%
|-valign="top"
|'''[[Syndrome of inappropriate antidiuresis]]'''
|[[Weakness]], [[dysgeusia]], and clinical euvolemia: [[osmolality]] <275 mOsmol/kg water, urinary osmolality >100 mOsmol/kg water during hypotonicity, urinary sodium >40 mmol/L with normal dietary salt intake.
|Frequency: 15-40%
|-valign="top"
|'''[[Cushing's syndrome]]'''
|Hypercorticism
|Frequency: 2-5%
|-valign="top"
|'''[[Lambert-Eaton syndrome]]'''
|Proximal muscles of lower extremities weakness and fatiguability, abnormal [[gait]], [[hyporeflexia]], increased deep-tendon reflexes after facilitation, [[autonomic dysfunction]], and [[paresthesia]]
|Frequency: 3%
|-valign="top"
|'''[[Limbic encephalitis]] and [[encephalomyelitis]]'''
|[[Altered mental status]], [[seizures]], [[memory loss]], space and time [[disorientation]], with or without [[dementia]].
|Frequency: <1%
|-valign="top"
|'''[[Paraneoplastic cerebellar degeneration]]'''
|[[Ataxia]], [[dysarthria]], ocular findings and severe [[vertigo]]
|Frequency: <1%
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Disease]]
[[Category:Disease]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Lung cancer]]
[[Category:Lung cancer]]
[[Category:Oncology]]
 
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Pulmonology]]
[[Category:Surgery]]

Latest revision as of 22:04, 4 September 2019

Small Cell Carcinoma of the Lung Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Small Cell Carcinoma of the Lung from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Radiation Therapy

Surgery

Prevention

Future or Investigational Therapies

Case Studies

Case #1

Small cell carcinoma of the lung history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Small cell carcinoma of the lung history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Small cell carcinoma of the lung history and symptoms

CDC on Small cell carcinoma of the lung history and symptoms

Small cell carcinoma of the lung history and symptoms in the news

Blogs on Small cell carcinoma of the lung history and symptoms

Directions to Hospitals Treating Small cell carcinoma of the lung

Risk calculators and risk factors for Small cell carcinoma of the lung history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2]; Rim Halaby, M.D. [3]

Overview

Small cell lung cancer (SCLC) is characterized by a relatively rapid onset of symptoms. Patients usually present within 8 to 12 weeks of the onset of symptoms, which can be related either to the tumor growth in the thorax or to the distant spread of the tumor. In addition, SCLC is associated with the occurrence of paraneoplastic syndromes such as the syndrome of inappropriate antidiuresis (SIADH).

History and Symptoms

History

Symptoms Related to Tumor Growth in the Thorax

Constitutional Symptoms

Symptoms Related to Paraneoplastic Syndromes

Symptoms Related to the Distant Spread of the Tumor

Uncommon Symptoms

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 van Meerbeeck JP, Fennell DA, De Ruysscher DK (2011). "Small-cell lung cancer". Lancet. 378 (9804): 1741–55. doi:10.1016/S0140-6736(11)60165-7. PMID 21565397.
  2. ↑ Beckles MA, Spiro SG, Colice GL, Rudd RM (2003). "Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes". Chest. 123 (1 Suppl): 97S–104S. PMID 12527569.
  3. ↑ 3.0 3.1 Gandhi L, Johnson BE (2006). "Paraneoplastic syndromes associated with small cell lung cancer". J Natl Compr Canc Netw. 4 (6): 631–8. PMID 16813730.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Spiro SG, Gould MK, Colice GL, American College of Chest Physicians (2007). "Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition)". Chest. 132 (3 Suppl): 149S–160S. doi:10.1378/chest.07-1358. PMID 17873166.
  5. ↑ Singh N, Madan K, Aggarwal AN, Das A (2013). "Symptomatic large bilateral adrenal metastases at presentation in small-cell lung cancer: a case report and review of the literature". J Thorac Dis. 5 (3): E83–6. doi:10.3978/j.issn.2072-1439.2011.09.05. PMC 3698258. PMID 23825789.
  6. ↑ Yildiz O, Buyuktas D, Ekiz E, Selcukbiricik F, Papila I, Papila C (2011). "Facial nerve palsy: an unusual presenting feature of small cell lung cancer". Case Rep Oncol. 4 (1): 35–8. doi:10.1159/000324182. PMC 3082487. PMID 21526004.


Template:WikiDoc Sources

Retrieved from "https://www.wikidoc.org/index.php?title=Small_cell_carcinoma_of_the_lung_history_and_symptoms&oldid=1581164"