Paraneoplastic syndromes in patients with liver cancer

Some patients with liver cancer present with the following paraneoplastic syndromes.

(1) Hypoglycemia: There are many reasons for hypoglycemia, such as liver cancer cells can ectopically secrete insulin-like substances, tumors store too much glycogen, inhibit insulin enzyme production or secrete pancreatic B cell stimulating factor, etc., which can lower blood sugar.

(2) Polycythemia: This may be caused by an increase in erythropoietin, and occurs in about 10% of patients.

(3) Hypercalcemia: Its occurrence may be related to the secretion of ectopic parathyroid hormone by liver cancer tissue. Hypercalcemia associated with liver cancer is different from hypercalcemia in bone metastasis. The latter is accompanied by hyperphosphatemia and often has clinical signs of bone metastasis to help differentiate. When liver cancer is associated with hypercalcemia, hypercalcemic crisis may occur, such as drowsiness, mental abnormalities, coma, etc., which are often misdiagnosed as hepatic encephalopathy or brain metastasis.

(4) Others: Hepatic porphyria, dysfibrinogenemia, thrombocytosis, hyperlipidemia, etc. may also occur.