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MCQ – 98151

Question

Which of the following are the non-metastatic extra-pulmonary manifestations of lung cancer?
  1. Carcinoid syndrome
  2. Nephrotic syndrome
  3. Horner’s syndrome
  4. Lambert-Eaton syndrome

 

A.

1, 2 and 3

B.

1, 2 and 4

C.

1, 3 and 4

D.

2, 3 and 4

Show Answer

Correct Answer » B

Explanation

Non-metastatic extrapulmonary manifestations of lung cancer are paraneoplastic syndromes, which occur due to hormone production, immune-mediated mechanisms, or other tumor-related factors, without direct tumor spread or metastasis.

The following are recognized paraneoplastic manifestations:

  • Carcinoid syndrome – Seen with bronchial carcinoid tumors due to secretion of serotonin and other vasoactive substances.
  • Nephrotic syndrome – A rare paraneoplastic manifestation, usually due to immune-mediated glomerular disease (e.g., membranous nephropathy).
  • Lambert–Eaton myasthenic syndrome (LEMS) – A classic paraneoplastic neurological syndrome, most commonly associated with small cell lung carcinoma (SCLC).

Why Other Options Are Incorrect

1. Carcinoid Syndrome

  • Correct.
  • A paraneoplastic/endocrine manifestation caused by secretion of serotonin and related substances.

2. Nephrotic Syndrome

  • Correct.
  • An uncommon paraneoplastic manifestation resulting from immune-mediated glomerular injury.

3. Horner’s Syndrome

  • Incorrect.
  • Horner’s syndrome results from direct local invasion of the cervical sympathetic chain, classically by a Pancoast (superior sulcus) tumor.
  • It is not a non-metastatic extrapulmonary (paraneoplastic) manifestation.

4. Lambert–Eaton Myasthenic Syndrome

  • Correct.
  • An autoimmune paraneoplastic syndrome caused by antibodies against presynaptic voltage-gated calcium channels.
  • Strongly associated with small cell lung carcinoma. 
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