Extrapulmonary lung cancer manifestations and paraneoplastic syndromes Flashcards
Why would a pt with lung cancer present with a hoarse voice?
Tumour in apex of lung pushes on recurrent laryngeal nerve as it passes through mediastinum
Why could a pt with lung cancer present with SOB?
tumour pressed on phrenic nerve causing phrenic nerve pasly = weakness of diagram and shortness of breath
Compression of what structure in a pt with lung cancer is a medical emergency and why?
superior vena cava compression - tumour pressing on it
What are the signs of a superior vena cava compression?
facial swelling, difficulting breathing, distended neck and upper veins
Permbertons sign - when hands raised above the head = facial decongestion and cyanosis
What syndrome can occur when tumour presses on stellate ganglion in neck?
Horners syndrome = loss of sympathetic drive = partial ptosis, anhidrosis and miosis.
A lung cancer pt presents with hyponatraemia - type of lung cancer and why?
small cell lung cancer
it secretes ectopic ADH causing syndrome of inappropriate ADH
What is Cushing syndrome and how does it relate to lung cancer?
Small cell lung cancers can produce ACTH and induce cushings syndrome (moon face, central obesity, buffalo hump, thin limb, proxmial muscle wasting, hirsutism)
How could a lung cancer pt have hypercalcaemia?
squamous cell carcinoma can secrete ectopic parathyroid hormone
What is limbic encephalitis and how does it relate to lung cancer>?
small lung cancer = immune system creates antibodies against limbic system in brain = short-term memory loss, confusion, seizures.
Anti-hu antibodies
what is lambert-eaton syndrome and how does it relate to lung cancer?
antibodies are produced against small cell lung cancer
they damage VG calcium channels in motor neurons
proximal weakness
double vision
drooping eye lids
slurred speech
dysphagia
