Paraneoplastic syndromes

Question 1

Give examples of why cancer can cause anorexia/cachexia as a neoplastic syndrome

Answer 1

Dysphagia
Pain 
Ascites
Anti cancer treatment
(Weight loss due to inappetence and tumour metabolism)

Question 2

What is ‘cutaneous flushing’? Which tumours is it seen with?

Answer 2

Neoplastic syndrome
Colour changes due to vasoactive substances produced by tumours
Phaeochromocytoma (adrenla gland), lung tumours, MCT

Question 3

How can anorexia/cachexia due to cancer be prevented/minimised?

Answer 3

Feeding tubes
Maropitant - for nausea
Mirtazapine, carpomellin - appetite stimulants

Question 4

Feline paraneoplastic alopecia is seen in older cats. Describe the lesions (are they itchy, symmetrical, local)

Answer 4

Non-pruritic
Symmetrical
Ventral abdomen and limbs
Glistening skin

Question 5

What tumour is associated with feline exfoliative dermatitis?

Answer 5

Thymoma

Feline thymoma-associated exfoliative dermatitis

Question 6

What paraneoplastic syndrome causes shifting lameness? What tumours is this seen with?

Answer 6

Hypertrophic osteopathy (Marie's disease)
Lung (or abdominal) tumours

Question 7

Nodular dermatofibrosis is a paraneoplastic syndrome seen with which breed of dog? What tumours/conditions cause this?

Answer 7

Middle-aged GSDs

Cystadenocarcinoma, bilateral renal cysts

Question 8

Pancreatic associated panniculitis is a paraneoplastic syndrome. What is panniculitis?

Answer 8

Inflammation of subcutaneous adipose tissue

Question 9

Give examples of paraneoplastic cytoses

Answer 9

Erythrocytosis
Neutrophilia (may be tumour induced or tumour response)
Eosinophilia

Question 10

Erythrocytosis is a paraneoplastic syndrome caused by tumours such as renal tumours, lymphoma, TVT and hepatic tumours. How is erythrocytosis treated?

Answer 10

Phlebotomy

Question 11

Paraneoplastic pemphigus and erythema multiforme isa very rare paraneoplastic syndrome seen with which tumours?

Answer 11

Lymphoma
Thymoma
Splenic sarcoma

Question 12

What neoplasia/disease causes superficial necrolytic dermatitis?

Answer 12

Pancreatic neoplasia

Hepatic disease

Question 13

Tumours can cause acute blood loss such as tumours of the spleen. Give examples of chronic causes of blood loss seen with tumours

Answer 13

Gastroduodenal ulcers (due to histamine release from MCTs, gastrin from gastrinomas)
Low grade haemorrhage from GI tumour

Question 14

Paraneoplastic hypercalcaemia, immune mediated anaemia and thrombocytopenia are secondary to which tumours (vague - not specific)?

Answer 14

Lymphoproliferative tumours

Question 15

Ectopic ACTH syndrome causes signs similar to Cushing’s. What tumours is this seen with?

Answer 15

Lung tumours

Question 16

Hypercalcaemia is mainly affected with which two tumours?

Answer 16

Anal sac adenocarcinoma

Lymphoma

Question 17

What is the treatment for hypercalcaemia as a neoplastic syndrome?

Answer 17

Rehydrate

Consider furosemide or prednisolone

Question 18

Which tumours can cause monoclonal gammopathies (XS antibody production - leads to hyperviscosity)?

Answer 18

Multiple myelomas

LymphomasLeukaemia

Question 19

How are monoclonal gammopathies treated?

Answer 19

Plasmapheresis (Separate plasma from blood)

Question 20

Protein losing enteropathy is particularly seen with which tumour? What is the major clinical sign?

Answer 20

GI lymphoma

Ascites

Question 21

Which tumours cause pyrexia and how?

Answer 21

Lymphoma, renal or hepatic tumours

Release inflammatory cytokines (in response to tumour or by tumour)

Question 22

What is myelophthisis? What tumours is it seen with?

Answer 22

Myelopthistic anaemia
Diseases affecting bone marrow
Causes neutropenia, then thrombocytopenia, then non-regenerative anaemia

Question 23

Anaemia of chronic inflammatory disease causes what type of anaemia?

Answer 23

Mild/moderate

Non-regenerative Normochromic normocytic

Question 24

What tumours cause hyperoestrogenism?

Answer 24

Testicular tumours (Often Sertoli cell)

Question 25

Which tumour can cause hypoglycaemia?

Answer 25

Insulinoma

Produces insulin