Paraneoplastic Drill

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Session History

Reference: Paraneoplastic Syndromes

Clinical Presentation	Frequently Associated Neoplasms	Etiology
Cushing syndrome	Small cell lung cancer Pancreatic cancer	Ectopic ACTH / CRH
SIADH	Small cell lung cancer	Ectopic vasopressin
Subacute cerebellar degeneration	Small cell lung cancer Breast, Ovarian, Uterine cancer	Anti-Yo, anti-P/Q & anti-Hu antibodies
Lambert–Eaton myasthenic syndrome	Small cell lung cancer	Voltage-gated calcium channel antibodies
Myasthenia gravis	Thymoma	Acetylcholine receptor antibodies
Hypercalcemia	Squamous cell lung cancer	Ectopic PTHrP
Dermatomyositis/polymyositis	Variable (Lung, Breast, GI)	Autoimmune
Erythrocytosis	Renal cell cancer	Ectopic erythropoietin

Tips & Mnemonics:

SCLC (Small Cell): The "3 Cs": Cushing, CNS (Lambert-Eaton/Cerebellar), SIADH.
Note: It is NOT associated with Hypercalcemia.
Hypercalcemia: "Squamous for Secretion of PTHrP."
Lambert-Eaton vs Myasthenia:
- Lambert-Eaton = Low (Pre-synaptic Ca channels).
- Myasthenia Gravis = Gone (Post-synaptic ACh receptors) + Thymoma.
Erythrocytosis: "Potentially Really High Hematocrit" = Pheochromocytoma, Renal Cell, HCC, Hemangioblastoma.