Clinical Conference
Paraneoplastic syndromes：diagnosis and management
Presentation: NO.7 Date: 10/24/2006
Students : B91609009 宋旆儀 Advisors : 李繼忠 老師
B91609016 吳鈞鴻 王尚麟 醫師
A. Abstracts
Cancer has many effects on the veterinary patient. One group of syndromes
that must be paid particular attention to is the paraneoplastic
syndromes(PNS). These are a group of changes that occur in the body at sites
distant from the actual tumor.
A timely detection of PNS is essential for several reasons: (1) they may be
the first clinical manifestation of tumor, and early diagnosis may improve
the prognosis for the underlying neoplasia (2) the severity of the PNS can
reflect the activity of the tumor cells, and give information on the
progressive or regressive nature of the tumor (3) the clinical signs caused
by a PNS could be falsely interpreted as direct effects of the tumor itself
or side effects of treatment, and lead to false prognostic considerations
(4) finally, PNS may affect the general condition of the animal, and
significantly alter the prognosis of a specific tumor.
Diagnosis of the PNS includes history taking, clinical signs, laboratory
findings, radiography, ultrasonagraphy…etc, and most important, ruling out
other possibilities (differential diagnosis).
Chronic treatment most commonly involves removal or treatment of the primary
or inciting neoplastic process. The acute treatment of these syndromes
involves symptomatic therapies and other miscellaneous management. Rapid
identification and treatment will allow the patient to have a better
prognosis and will help to improve quality of life.
PNS can affect many different body systems. They include general,
gastrointestinal, endocrinologic, hematologic, cutaneous, and miscellaneous
disorders.
B. Outline
Definition-
Importance of PNS-
General-
Cancer cachexia
Fever
Gastrointestinal-
Protein-Losing Enteropathy (PLE)
Gastroduodenal Ulceration
Endocrinologic-
Hypercalcemia of Malignancy (HM)
Hypoglycemia
Ectopic Adrenocorticotropic Hormone (ACTH) Syndrome
Hematologic-
Hypergammaglobulinemia
Anemia
Erythrocytosis
Neutrophilic Leukocytosis
Hypereosinophilia
Thrombocytopenia
Thrombocytosis
Coagulation disorders
Cutaneous-
Feline paraneoplastic alopecia
feline thymoma-associated exfoliative dermatitis
nodular dermatofibrosis
superficial necrolytic dermatitis
paraneoplastic pemphigus
Miscellaneous-
Myasthenia Gravis (MG)
Hypertrophic Osteopathy (HO)
Conclusion-
C. Reference
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