[Paraneoplastic syndromes in internal medicine]

Paraneoplastic syndromes supplement the complex clinical picture of malignomas. Their knowledge improves early diagnosis. The development, course and regression of paraneoplastic syndromes indicates that they have a multifactorial origin and their manifestation depends on the biochemical, metabolic and immunological situation of the organism. The pathogenesis involves many obscure points and the clinical picture is often a surprise, an unexpected variant with regard to theoretical expectations. Sometimes paraneoplastic syndromes prove fatal in patients with a tretable tumour. There does not exist any paraneoplastic syndrome specific for a certain malignoma. In the authors' group of 1538 patients with malignant tumours belonging into the competence of internal medicine a paraneoplastic syndrome was found in 282 (18.3% patients). In 144 (9.4%) it was the first symptom of disease, incl. 74 (4.8%) where it was also an early sign of the disease. In the group thrombohaemorrhagic and rheumatological paraneoplastic syndrome was most frequently encountered. The relatively highest incidence of early paraneoplasias was observed in those malignomas which affect the immunocompetent apparatus (immunocytomas, haemoblastoses, and lymphomas). The authors recommend that suspect paraneoplastic syndromes should be dispensarized as precanceroses.