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Zusammenfassung

Die erweiterten Kenntnisse über die unspezifischen Fernwirkungen bösartiger Geschwülste auf den Gesamtorganismus haben in den letzten Jahrzehnten zur eingehenden Erforschung der Ursachen und Zusammenhänge geführt. Unabhängig von dem Malignitätsgrad des Primärtumors und seiner Tochtergeschwülste ist eine erstaunliche Vielfalt von begleitenden klinischen Symptomen beschrieben worden, die nicht mit der Art, der Größe und der Lokalisation einer Geschwulst erklärt werden können. Es handelt sich um funktionelle oder organische Störungen, die bei Tumorpatienten beobachtet werden, jedoch keineswegs auf direkte oder lokale Einwirkungen der Geschwulst zurückgeführt werden können. Derartige Symptome oder Befunde können entweder gleichzeitig mit einem Tumor klinisch in Erscheinung treten, einige Zeit vor dem Tumornachweis aber auch erst nach Entdeckung der Geschwulst bemerkt werden. Die Vorstellung, daß ein Zusammenhang zwischen diesen paraneoplastischen Symptomen und dem Tumorleiden bestehen muß, konnte durch Beobachtungen gestützt werden, die eine Rückbildung der Symptome nach operativer Entfernung der Geschwulst oder ein erneutes Auftreten bei einem Tumorrezidiv sowie Tochtergeschwülsten feststellten. Da fundierte Kenntnisse über die Zusammenhänge im einzelnen fehlten, wurden die verschiedenartigsten Symptome unter dem Begriff der „paraneoplastischen Syndrome“ oder der „Paraneoplasie“ zusammengefaßt, obgleich Einzelbeispiele von unspezifischen Fernwirkungen bösartiger Tumoren seit etwa 100 Jahren bekannt und auch mitgeteilt worden sind. So hat VIRCHOW (1855) auf Zusammenhänge zwischen Organverkalkungen bei Hyperkalzämie und Malignomen hingewiesen. Die atypischen Thrombosen bei okkulten Magen- und Pankreas-Karzinomen (TROUSSEAU 1865/77) und die Acanthosis nigricans als kutane Manifestation eines viszeralen Tumors sind in den Lehrbüchern der klinischen Medizin zu finden.

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© Springer-Verlag Berlin Heidelberg 1983

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  • F. Heuck

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