Symptoms complex seen in cancer patient and that can’t be readily explain by local or distal spread of tumor or by elaboration of hormones indigenous to tissues of origin of tumor.
This is more important because,
- Earliest manifestation of occult tumor
- Significant clinical problems to the patient
- Mimic metastatic diseases
- Confound treatments
1. Endocrine pithy
Elaboration of hormones or hormone like substance by cancer cells of non endocrine origin. This is an ectopic hormone production.
- PTH like substance is secreted by squamous cell carcinoma of the lung causing hyper calceamia.
- ACTH like substance is secreted by small cell carcinoma of the lung causing Cushing syndrome.
- Polysytheamia is caused by erythropoietin secretion of renal cell carcinorma or hepato cellular carcinoma.
- Hypoglycaemia is caused by secretion of insulin or insulin like substance by fibro sarcoma or hepato cellular carcinorma.
Sometimes bronchogenic carsinorma cause peripheral neuropathy, myasthenia gravis, polymyocitis mediated by immunogenic mechanism without brain metastasis.
3. Osceous, Articular, Soft tissue changes
Bronchogenic carcinoma cause clubbing of fingers, hyperthophic osteoarthropathy. (by unknown mechanism)
4. Dermatological problems
Acanthosis nigricance caused by gastric, uterine lung carcinoma.
5. Hematological and vascular problems
Some cancers like Pancreatic carcinoma and Bronchogenic carcinoma cause venous thrombosis, disseminated intravascular coagulation (DIC), autoimmune haemolytic anaemia, non bacterial thrombotic endocarditis.