Paraneoplastische Syndrome

Paraneoplastische Syndrome werden durch Zytokine, Hormone oder Kreuzreaktivität des Immunsystems vermittelt, können verschiedene Krankheitsbilder hervorrufen und multiple Organsysteme betreffen. Erkennt man sie rechtzeitig, kann das eine frühzeitige Diagnosestellung und Behandlung ermöglichen. Im Folgenden werden die Bildgebungsmerkmale von häufiger anzutreffenden PNS, ihre assoziierten Malignome und onkoneuralen Antikörper vorgestellt.

Abstract

In everyday radiological practice, the evaluation of malignant masses and their complications, such as displacement and infiltration of adjacent structures or metastasis, is part of the routine. However, there are also patients who present with symptoms that cannot be explained by direct tumor infiltration but rather secondary effects of their underlying malignancy in the context of a paraneoplastic syndrome (PNS). These symptoms are mediated by cytokines, hormones, or immune system cross-reactivity, and they can trigger various characteristic clinical pictures, affecting multiple organ systems. PNS occur in up to 15% of cancer patients. Knowledge of the clinical and radiological manifestations of different PNS is essential, as these syndromes can allow for early tumor diagnosis, complicate the clinical presentation of a patient, indicate a response to therapy, and may also be mistaken for metastatic spread.

Kernaussagen

• PNS sind eine heterogene Gruppe, die vielfältige Darstellungsformen haben, multiple Organsysteme betreffen und sich bereits vor einer Krebsdiagnose manifestieren können.

• PNS sind relativ selten und erfordern den Ausschluss häufiger auftretender Erkrankungen.

• Die Kenntnis des Spektrums der zugrunde liegenden Tumoren der PNS trägt wesentlich dazu bei, die diagnostische Bildgebung für Patienten individuell anzupassen.

• Radiologen sollten sich der Bildgebungsbefunde und potenziellen diagnostischen Fallstricke der PNS bewusst sein, da dies eine rechtzeitige Diagnose zugrunde liegender Tumoren ermöglichen und sich positiv auf das klinische Outcome dieser Patienten auswirken kann.

Schlüsselwörter

limbische Enzephalitis - Myasthenia gravis - Cushing-Syndrom - Syndrom der inadäquaten ADH-Sekretion - Hyperkalzämie - Polymyositis - hypertrophe Osteoarthropathie - Ganzkörper-Hybridbildgebung

Keywords

limbic encephalitis - myasthenia gravis - Cushing's syndrome - syndrome of inappropriate antidiuretic hormone secretion - hypercalcemia - polymyositis - hypertrophic osteoarthropathy - whole-body hybrid imaging

Publikationsverlauf

Artikel online veröffentlicht:
05. Juni 2025

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