Paraneoplastic syndromes in pancreatic cancer.

Paraneoplastic syndromes are defined as signs and symptoms which presentdistant to the site of primary cancer or metastases. However, they are closelyassociated with the malignant disease and comprise metabolic, dystrophic, and/ordegenerative symptoms, which are consequences of humoral or hormonal factors. The clinical symptoms vary widely and include systemic and organ-specificmanifestations. In some cases, these can become the major clinical problems determining survival. Systemic manifestations include frequent symptoms ofpancreatic cancer patients such as fever and cachexia. Organ-specific symptomsmay represent as cutaneous, neurological, hematological, or endocrine symptoms. A special focus of this chapter is on diabetes mellitus associated withpancreatic tumors. The best-understood syndromes result from tumor productionof biologically active substances or, to a lesser extent, from autoimmune phenomena. Biological active agents may promote the growth of the tumor directly. In turn, growth-promoting agents of this type may become the focus of newapproaches to anticancer treatment. After successful treatment of the underlyingmalignant disease, paraneoplastic symptoms may resolve completely. Thus, earlyrecognition of paraneoplastic syndromes is very important in the management ofpatients with pancreatic cancer. In the following chapter, the most commonparaneoplastic syndromes are described in detail