Of particular interest are the non metastatic para-neoplastic syndromes associated with lung cancer. These are particularly well documented for small cell carcinoma and large cell undifferentiated carcinoma, both of which tend to have many neuro-endocrine features. But they do occur to a lesser degree with squamous and adenocarcinoma. Many of these syndromes are mediated by peptides which mimic active portions of known hormones. The common para-neoplastic syndromes are listed below.

While they are often no more than clinical curiosities it is important that when the syndromes are diagnosed that an underlying carcinoma must be suspected. It is also important to realise that these are not symptoms of metastatic disease and the tumour itself may be curable with appropriate therapy to the primary site. Frequently it is necessary to control the para-neoplastic symptom in order to make the patient fit enough to undergo radical therapy.

Common paraneoplastic syndromes associated with lung cancer

Endocrine

1. •Syndrome of inappropriate anti-diuretic hormone (SIADH)
   

2. •Atrial natriuretic peptide
   

3. •Ectopic adrenocorticotropic hormone
   

4. •Hypercalcaemia (Non-metastatic)
   

Neurological

1. •Eaton-Lambert myasthenic syndrome
   

2. •Paraneoplastic cerebellar degeneration
   

3. •Encephalomyelitis
   

4. •Sensory neuropathy
   

5. •Retinopathy
   

6. •Intestinal pseudo-obstruction
   

7. •Autonomic dysfunction
   

Other

1. •Hypercoagulability
   

2. •Nephrotic syndrome
   

3. •Hypertrophic pulmonary osteoarthropathy (HPOA)