review

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review paraneoplastic syndromes Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment Lorraine C. Pelosof, MD, PhD, and David E. Gerber, MD Recent medical advances have improved the understanding, di- agnosis, and treatment of paraneoplastic syndromes. These dis- orders arise from tumor secretion of hormones, peptides, or cytokines or from immune cross-reactivity between malignant and nor- mal tissues. Paraneoplastic syndromes may affect diverse organ systems, most notably the endocrine, neurologic, dermatologic, rheumatologic, and hematologic systems. The most commonly as- sociated malignancies include small cell lung cancer, breast can- cer, gynecologic tumors, and hematologic malignancies. In some instances, the timely diagnosis of these conditions may lead to detection of an otherwise clinically occult tumor at an early and highly treatable stage. Because paraneoplastic syndromes often cause considerable morbidity, effective treatment can improve pa- tient quality of life, enhance the delivery of cancer therapy, and prolong survival. Treatments include addressing the underlying malignancy, immunosuppression (for neurologic, dermatologic, and rheumatologic paraneoplas...