Ectopic hormone production would only be an epiphenomenon associated with cancer if it did not result in clinical manifestations. Excessive and unregulated production of hormones such as ACTH, PTHrP, or vasopressin can lead to substantial morbidity and can complicate the cancer treatment plan. Moreover, the paraneoplastic endocrinopathies are sometimes the presenting feature of underlying malignancy and may prompt the search for an unrecognized tumor. A large number of paraneoplastic endocrine syndromes have been described, linking overproduction of particular hormones with specific types of tumors. However, certain recurring syndromes emerge from this group (Table 961). The most common paraneoplastic endocrine syndromes. | Chapter 096. Paraneoplastic Syndromes Endocrinologic Hematologic Part 2 Ectopic hormone production would only be an epiphenomenon associated with cancer if it did not result in clinical manifestations. Excessive and unregulated production of hormones such as ACTH PTHrP or vasopressin can lead to substantial morbidity and can complicate the cancer treatment plan. Moreover the paraneoplastic endocrinopathies are sometimes the presenting feature of underlying malignancy and may prompt the search for an unrecognized tumor. A large number of paraneoplastic endocrine syndromes have been described linking overproduction of particular hormones with specific types of tumors. However certain recurring syndromes emerge from this group Table 961 . The most common paraneoplastic endocrine syndromes include hypercalcemia from overproduction of PTHrP and other factors hyponatremia from excess vasopressin and Cushing s syndrome from ectopic ACTH. Table 96-1 Paraneoplastic Syndromes Caused by Ectopic Hormone Production Paraneoplastic Syndrome Ectopic Hormone Typical Tumor Types Common Hypercalcemia of malignancy Parathyroid hormone-related protein PTHrP Squamous cell head and neck lung skin breast genitourinary gastrointestinal 1 25 dihydroxyvitamin D Lymphomas Parathyroid hormone PTH rare Lung ovary Prostaglandin E2 Renal lung PGE2 rare Syndrome of inappropriate antidiuretic hormone secretion SIADH Vasopressin Lung squamous small cell gastrointestinal genitourinary ovary Cushing s syndrome Adrenocorticotropic hormone ACTH Lung small cell bronchial carcinoid adenocarcinoma squamous thymus pancreatic islet medullary thyroid carcinoma Corticotropin- releasing hormone CRH rare Pancreatic islet carcinoid lung prostate Ectopic expression of gastric inhibitory peptide GIP luteinizing hormone LH human Macronodular adrenal .
