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

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==History and Symptoms==
==History and Symptoms==
*Patients are typically men older than 40 yearsheavy current or ex-smokers and have a lot of pulmonary, cardiovascular, and metabolic comorbidities.<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>
===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]]<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]]<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>


*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>
===Constitutional Symptoms===
* [[Fatigue]]
* [[Anorexia]]
* [[Weight loss]]


:::*[[Cough]] 75%
===Symptoms Related to Paraneoplastic Syndrome===
:::*[[Weight loss]] 68%
:::*[[Dyspnea]] 60%
:::*[[Chest pain]] 49%
:::*[[Hemoptysis]] 35%
:::*[[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 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 C8, 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 (suggestive of [[lymphadenopathy]])


*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's 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>
===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>
* [[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>


*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>
*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>
:::*[[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 [[superior vena cava syndrome]] and the [[syndrome of inappropriate antidiuresis]] the most common.<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="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>
*SCLC is the most frequent cause of [[paraneoplastic syndromes]], being the [[superior vena cava syndrome]] and the [[syndrome of inappropriate antidiuresis]] the most common.<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="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>

Revision as of 13:56, 19 June 2014

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

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.[1] 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. [2]

History and Symptoms

Symptoms Related to Tumor Growth in the Thorax

Constitutional Symptoms

Symptoms Related to Paraneoplastic Syndrome

Symptoms Related to the Distant Spread of the Tumor

Uncommon Symptoms


Superior vena cava syndrome Edema of upper body, visible dilated veins over the upper torso, shoulders and arms, headache, dizziness, drowsiness, blurring of vision, cough, dysphagia Frequency: 50%
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%
Hypercalcemia Nausea, vomiting, abdominal pain, constipation, polyuria, thirst, dehydration, confusion, irritability Frequency: 8-12%
Cushing's syndrome Hypercorticism Frequency: 2-5%
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%
Limbic encephalitis and encephalomyelitis Altered mental status, seizures, memory loss, space and time disorientation, with or without dementia. Frequency: <1%
Paraneoplastic cerebellar degeneration Ataxia, dysarthria, ocular findings and severe vertigo Frequency: <1%

Hypercalcemia is characteristically uncommon in SCLC patients.

References

  1. Sher T, Dy GK, Adjei AA (2008). "Small cell lung cancer". Mayo Clin Proc. 83 (3): 355–67. doi:10.4065/83.3.355. PMID 18316005.
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 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.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 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.
  4. 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.
  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.
  7. Ellison DH, Berl T (2007). "Clinical practice. The syndrome of inappropriate antidiuresis". N Engl J Med. 356 (20): 2064–72. doi:10.1056/NEJMcp066837. PMID 17507705.
  8. Boscaro M, Arnaldi G (2009). "Approach to the patient with possible Cushing's syndrome". J Clin Endocrinol Metab. 94 (9): 3121–31. doi:10.1210/jc.2009-0612. PMID 19734443.

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