临床肿瘤学(2003年英文版)第24章-第33章chapter31【荐】.pdfVIP

31 Paraneoplastic OVERVIEW Tumors produce signs and symptoms by two major mechanisms. One involves dysfunction of normal tis- and Endocrine sues owing to invasion, compression, or destruction by a primary tumor or its metastases. The other involves Syndromes distant or “remote” effects of the malignancy owing to the elaboration of biologically active substances that en- ter the circulation and cause physiologic changes. These remote effects are known collectively as paraneoplastic syndromes. A paraneoplastic syndrome may precede the diagno- sis of an underlying malignancy by months to years, may occur as the presenting symptom, or may develop Paul E. Rosenthal during the course of the illness [1]. Up to 50% of pa- tients with cancer will be affected by at least one para- neoplastic syndrome at some time during their illness. Prompt recognition that a given symptom