21st February 2025

Complications of lung cancer

Metastases

Common sites to which lung cancers metastasise include the brain, bones, liver and adrenals.

Paraneoplastic syndromes

Paraneoplastic syndromes are frequently seen in lung cancer, especially in association with small cell lung cancer.

Table 3 Paraneoplastic syndromes associated with lung cancer

Horner’s syndrome

Pancoast tumours (tumours in the lung apex) can involve the sympathetic chain, leading to Horner’s syndrome: ipsilateral ptosis, miosis and anhidrosis.

Superior vena cava obstruction (SVCO)

Lung cancer is the most common malignancy to cause SVCO.

Lymphangitis carcinomatosa

Lymphangitis carcinomatosa is the infiltration of cancer cells into the lymphatic system, leading to inflammation. Pulmonary lymphangitis carcinomatosa is rare but important as it can cause severe symptoms and is associated with a poor prognosis (around half of patients will die within two months of first developing symptoms). Symptoms include shortness of breath and a dry cough. Imaging findings may be similar to those of interstitial lung disease. Lymphangitis is most commonly associated with lung, breast and gastrointestinal cancers.

The most effective treatment is treatment of the underlying cancer. Steroids may be trialled for symptom control.