Paraneoplastic syndromes associated with gastric cancer

Case: 42 years old male is admitted to ICU with severe uncontrolled hypertension (HTN). Subsequent workup led to the diagnosis of polyarteritis nodosa (PAN) due to gastric cancer. This tends to be a good sign.

A) True

B) False

Answer: A

Although paraneoplastic manifestations of gastric tumor are usually late in the disease, polyarteritis nodosa is unique in a sense that it appears early as a single manifestation and a sign of a surgically curable gastric cancer.

Other paraneoplastic manifestations are "sign of Leser-Trélat", acanthosis nigricans, microangiopathic hemolytic anemia, membranous nephropathy, and hypercoagulable states popularly known as Trousseau's syndrome.

#oncology

#rheumatology

References:

1. Poveda F, González-García J, Picazo ML, et al. Systemic polyarteritis nodosa as the initial manifestation of a gastric adenocarcinoma. J Intern Med 1994; 236:679.

2. Taketa T, Ohigashi S, Suzuki K, Sudo K, Shiozaki H, Suzuki A, Blum MA, Ajani JA, Onodera H. Paraneoplastic neurological syndromes associated with gastric cancer: a case report and review of the literature. Clin J Gastroenterol. 2012 Oct;5(5):355-60. doi: 10.1007/s12328-012-0328-z. Epub 2012 Aug 28. PMID: 26181075.