Small cell carcinoma of the lung history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Guillermo Rodriguez Nava, M.D. [2]
Overview
Small cell lung cancer (SCLC) is characterized by a relatively rapid onset of symptoms.[1] Patients usually present within 8 to 12 weeks of the onset of symptoms which include symptoms related either to tumor growth in the throax such as cough, dyspnea, or hemoptysis, or symptoms related to distant spread.[1] In addition, SCLC is associated with the occurrence of paraneoplastic syndromes such as the syndrome of inappropriate antidiuresis (SIADH).[1]
History and Symptoms
History
SCLC is characterized by a relatively rapid onset of symptoms. Patients with SCLC usually present within 8 to 12 weeks of the onset of symptoms. A typical SCLC patient is a 70 year old male who is either a smoker or an ex-smoker.[1]
Symptoms Related to Tumor Growth in the Thorax
Constitutional Symptoms
Symptoms Related to Paraneoplastic Syndrome
- Syndrome of inappropriate antidiuresis (SIADH) (frequency: 15-40%): non specific symptoms such as weakness[1]
- Hypercalcemia (frequency: 8-12%): nausea, vomiting, abdominal pain, constipation, polyuria, thirst, dehydration, confusion, irritability[1]
- Cushing's syndrome (frequency: 2-5%): rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity), a round face often referred to as a "moon face", excess sweating, insomnia, reduced libido, amenorrhoea[1]
- Lambert-Eaton syndrome(frequency: 3%): weakness of the proximal muscles of lower extremities, abnormal gait, autonomic dysfunction, and paresthesia[1]
- Limbic encephalitis and encephalomyelitis (frequency <1%): altered mental status, seizures, memory loss, space and time disorientation, with or without dementia[1]
- Paraneoplastic cerebellar degeneration (frequency <1%): ataxia, dysarthria, severe vertigo[1]
- Amenorrhea (due to production of prolactin or growth hormone)[3]
- Galactorrhea (due to production of prolactin or growth hormone)[3]
Symptoms Related to the Distant Spread of the Tumor
- Hoarseness (involvement of the recurrent laryngeal nerve)[4]
- Dyspnea (one of the causes is the involvement of the phrenic nerve and subsequent elevation of the hemi-diaphragm)[4]
- Pain, muscle wasting, or change in the skin temperature in areas corresponding to C8, T2 to T4 (involvement of the brachial plexus)[4]
- Chest pain (one of the causes is the involvement of the chest wall)[4]
- Pleuritic chest pain[4]
- Horner syndrome manifested by unilateral miosis, ptosis and anhydrosis (involvement of the sympathetic trunk)[4]
- Arrhythmia (involvement of the pericardium)[4]
- Cardiac tamponade manifested by chest pain, altered mental status, cold extremities, peripheral cyanosis (involvement of the pericardium)[4]
- Dysphagia (compression of the esophagus)[4]
- Superior vena cava syndrome manifested by dyspnea, headache, and swelling of the face, neck, trunk, and arms[4]
- Localized bone pain most commonly on the axial skeleton and proximal long bones (suggestive of bone metastasis)
- Jaundice (suggestive of liver metastasis)
- Headache, nausea and vomiting, focal neurologic symptoms, seizures, confusion, and personality changes (suggestive of brain metastasis)
- Palpable masses (suggestive of lymphadenopathy)
Uncommon Symptoms
- Abdominal discomfort due to bilateral adrenal mass[5]
- Facial nerve palsy due to metastasis to the facial nerve[6]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 van Meerbeeck JP, Fennell DA, De Ruysscher DK (2011). "Small-cell lung cancer". Lancet. 378 (9804): 1741–55. doi:10.1016/S0140-6736(11)60165-7. PMID 21565397.
- ↑ Beckles MA, Spiro SG, Colice GL, Rudd RM (2003). "Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes". Chest. 123 (1 Suppl): 97S–104S. PMID 12527569.
- ↑ 3.0 3.1 Gandhi L, Johnson BE (2006). "Paraneoplastic syndromes associated with small cell lung cancer". J Natl Compr Canc Netw. 4 (6): 631–8. PMID 16813730.
- ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 Spiro SG, Gould MK, Colice GL, American College of Chest Physicians (2007). "Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition)". Chest. 132 (3 Suppl): 149S–160S. doi:10.1378/chest.07-1358. PMID 17873166.
- ↑ Singh N, Madan K, Aggarwal AN, Das A (2013). "Symptomatic large bilateral adrenal metastases at presentation in small-cell lung cancer: a case report and review of the literature". J Thorac Dis. 5 (3): E83–6. doi:10.3978/j.issn.2072-1439.2011.09.05. PMC 3698258. PMID 23825789.
- ↑ Yildiz O, Buyuktas D, Ekiz E, Selcukbiricik F, Papila I, Papila C (2011). "Facial nerve palsy: an unusual presenting feature of small cell lung cancer". Case Rep Oncol. 4 (1): 35–8. doi:10.1159/000324182. PMC 3082487. PMID 21526004.