PARANEOPLASTIC SYNDROMES

Aim. To draw attention of the medical community, especially oncologists, internists, rheumatologists, endocrinologists, and dermatologists to a special symptom complex that often accompanies tumor process and manifests in the form of the socalled "paraneoplastic syndrome" (PNS). Material and Methods. The paper analyzes literature sources touching upon the problems of PNS statistics, ethiology and pathogenesis. The frequency of syndrome detection by different doctors and practical value of such observations is considered. In addition, a retrospective analysis of previous own papers on tumor toxicosis, which from the present-day perspective could be interpreted as evidence of PNS, is conducted. Results and Discussion. Except local symptoms caused by tumor, a number of pathological manifestations are known; they are not directly connected to the tumor or its metastases, and appear at some distance from primary site. Such manifestations are united under the notion of PNS. It is believed that appearance of PNS is connected with endocrine, immunological or metabolic influences of the tumor. Over 600 of such syndromes have already been described, and their number is constantly increasing. For clinicians, these syndromes are of diagnostic value, and can be used for monitoring during and after treatment. Different views of different specialists - oncologists, rheumatologists, dermatologists, nephrologists, etc. - on the syndrome are discussed. In due time, a number of studies were conducted at the department of oncology in order to study toxic phenomena accompanying malignant tumors. On comparison of our findings with descriptions of PNS, many similarities are found. It is possible that the successful "detoxicating" therapy given by us was unknowingly aimed at PNS and, therefore, sporadically produced surprisingly good results. Introduction to paraneoplastic syndromes is useful for doctors of any "narrow" specializations, as all of them encounter malignant diseases, and, consequently, paraneoplastic processes. The ability of a physician to diagnose not only the main oncological disease, but also the accompanying paraneoplastic process proves their clinical erudition and has a positive impact on the whole diagnostic and treatment process. We should remember that paraneoplastic manifestations may mask not only oncological, but also a number of other pathological processes. Conclusions. The above given analysis of literature data and the authors' own observations allow making the following conclusions: 1. Paraneoplastic syndromes are characterized by some common etiological and pathogenetic manifestations. 2. Real paraneoplastic syndromes develop only in the presence of a tumor. 3. Clinical and laboratory manifestations of paraneoplastic syndromes are non-specific and are encountered in the presence of other chronic processes. 4. No correlation was found between the degree of paraneoplastic syndrome manifestation and clinical manifestations of tumors. 5. The majority of paraneoplastic syndromes show resistance to the applied symptomatic treatment. 6. The majority of paraneoplastic syndromes disappear without additional treatment after successful tumor curative therapy. Keywords: malignant tumors (cancer), paraneoplastic syndromes, cancer toxicosis