Periarticular paraneoplastic syndrome associated with lung cancer

Yu.V. Dumanskiy, O.V. Syniachenko, F.A. Stepko, S.N. Verzilov


Background. Paraneoplastic syndrome (PNPS) associated with lung cancer (LC) is characterized by rheumatologic and neurologic periarticular manifestations. PNPS has become an urgent problem of modern oncology, but features of its course and development of tumor process itself are underinvestigated. The purpose was to estimate clinical laboratory manifestations of paraneoplastic (neoplasmic) periarticular syndrome (PAS) within the context of correlation with some signs of LC. Materials and methods. PNPS was detected in 258 (16 %) patients with LC, and PAS — in 114 (44 %) cases of PNPS. These patients (83 men and 31 women with an ave-rage age of 59 years) made up the main study group, and the remai-ning 144 patients with PNPS were included into comparison group. Results. Among patients with paraneoplastic PAS, osteoarthropathy was diagnosed in 24 % of cases, peripheral neuropathy — in 11 %, fibrositis and tendovaginitis — in 6 %, fasciitis and enthesopathy — in 4 %, algodystrophy — in 3 %, which in comparison with the others persons with PNPS more often develops in women (by 1.9 times) and localize in the middle lobe (by 3.8 times). Also, these patients more often have squamous histological variant of tumor (by 1.5 times), its extension into chest wall (by 2.1 times), compression of recurrent nerve (by 3.8 times), a large number of groups of metastases in lymph nodes (by 1/4), but they do not have bilateral pulmonary involvement, large-cell carcinoma (by 3.2 times), compression syndrome (by 4.0 times), neoplasm extension into trachea (by 2.5 times), which depends on the power of chemotherapy, used platinum-based drugs, alkylating agents, vinca alkaloids and anthracyclines, while periarticular paraneoplastic manifestations lead to myelodepression, radiation-induced pulmonary fibrosis and esophagitis. Conclusions. Formation of paraneoplastic PAS is observed in almost every second patient with PNPS associated with LC, which is accompanied by the features of tumor process, and obtained data necessitate the further investigations to develop criteria for early diagnosis of PAS and informative prognostic factors for the further course of LC.


cancer; lung; paraneoplastic periarticular syndrome


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