Endocrine syndromes associated with malignancy
The hormones tumours make (ADH, PTHrP, ACTH, big IGF-2, FGF23, hCG, calcitriol, EPO), which tumours make them and the biochemical pattern of each, how to tell paraneoplastic from treatment-related endocrinopathies, and the first-line fixes while the cancer is treated.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Tumours can secrete a hormone (ectopic production), a hormone-like peptide, or an enzyme that activates one. The syndrome may precede the cancer diagnosis or flag a recurrence.
- The big three in physician exams are SIADH, PTHrP hypercalcaemia and ectopic ACTH, all classically from lung cancer.
- Treatment has two arms: correct the metabolic problem now, and treat the tumour, which is the only lasting fix.
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Sources
- Therapeutic Guidelines: Oncology and Palliative Care, and EndocrinologyAU/NZTherapeutic Guidelines Ltd
- eviQ Cancer Treatments Online (oncological emergencies; immunotherapy endocrine toxicity)AU/NZCancer Institute NSW
- El-Hajj Fuleihan G et al. Treatment of hypercalcemia of malignancy in adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2023;108:507-28Endocrine Society, 2023 (no newer version found, November 2026)
- Nieman LK et al. The diagnosis of Cushing's syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2008;93:1526-40Endocrine Society, 2008
- Fleseriu M et al. Consensus on diagnosis and management of Cushing's disease: a guideline update. Lancet Diabetes Endocrinol 2021;9:847-75Pituitary Society, 2021
- Spasovski G et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. Eur J Endocrinol 2014;170:G1-G47European Society of Endocrinology, ESICM and ERBP, 2014
- Cryer PE et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2009;94:709-28Endocrine Society, 2009
- Haanen J et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guideline. Ann Oncol 2022;33:1217-38European Society for Medical Oncology, 2022
- Pelosof LC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc 2010;85:838-54Mayo Clinic Proceedings, 2010
- Last updated
- 14 November 2026
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