Regarding Lung Cancer....

A 65-yr -old woman has been diagnosed as having lung cancer. Which of the following statements is most appropriate?
A. Hypertrophic pulmonary osteoarthropathy (HPOA) is commonly seen pts with small-cell
carcinoma
B. SIADH is commonly seen in pts with squamous-cell carcinoma
C. Hypercalcaemia may occur without bone metastasis
D. Paraneoplastic syndromes occur more commonly with squamous-cell carcinomas
E. Hypercalcaemia associated with bone metastasis is best treated with intravenous steroids

 Answer:
C. Hypercalcaemia may occur without bone metastasis

Discussion: Paraneoplastic syndromes are a variety of non metastatic metabolic or neuromuscular
manifestations of lung cancer. They are commonly associated with small-cell carcinoma.

Hypertrophic pulmonary osteoarthropathy (HPOA)  is characterised by painful symmetrical arthropathy involving the wrist, ankle and knee joints. It is most commonly seen in pts with adenocarcinoma and is virtually unknown in those with small cell carcinoma.

SIADH is most common in pts with small-cell carcinoma.

Hypercalcaemia may occur as a paraneoplastic syndrome with squamous-cell carcinoma. This is due to the production of a parathyroid hormone-related peptide by the tumour, which increases bone resorption, and renal tubular reabsorption of calcium. This is best treated with intravenous fluids and
bisphosphonates.

Steroids are mainly used for treating hypercalcaemia associated with sarcoidosis.