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3.6. Acromegaly Syndrome

Acromegaly has been described in a small number of patients with nonpituitary tumors, mainly carcinoids and pancreatic islet cell tumors [10]. The mechanism involved in this syndrome is the production of growth hormone (GH)-releasing hormone by the tumor cells, which stimulates the pituitary to secrete GH in excessive amounts. Only rarely has GH itself been described as a product of cancer.

3.7. Erythrocytosis Syndrome

Production of red blood cells is normally controlled by erythropoietin (EPO)—a hormone produced by renal cells. Although carcinomas of the kidney have most commonly been associated with polycythemia, other types of neoplasms like hepatocellular carcinoma, cerebellar hemangioblastoma, and even chronic lymphatic leukemia have been described [11]. Increased EPO levels are the presumed mechanism causing polycythemia, although measurable EPO levels poorly correlate with the degree of polycythemia.

3.8. Oncogenic Osteomalacia Syndrome

This rare syndrome is associated with hypophosphatemia, hyperphosphaturia, osteomalacia and low 1,25 OH vitamin D levels in the serum. About 80% of the reported cases are caused by pleomorphic neo plasms, another 11 % by oat cell carcinoma of the lung and about 7% by prostatic carcinoma [12], The presumed mechanism of this syndrome is inhibition of phosphorus renal cell absorption by a protein not yet characterized, which is produced by the tumor cells.

3.9. Hyper-Reninemic Syndrome

Increased plasma renin levels causing hypertension and hypokalemia have been rarely described in tumors arising from the juxtaglomerular apparatus. More rarely, this syndrome has been described in case reports in other tumors outside the kidney.

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