History
Extrapulmonary small cell carcinoma is an aggressive neoplasm that enlarges rapidly and disseminates early in the course of illness. Due to the multiplicity of sites where it can arise, there are no symptoms or signs specifically attributable to extrapulmonary small cell carcinoma. Patients may present with constitutional symptoms of fatigue, weakness, fever, weight loss, and night sweats. They may also have symptoms referable to the organ of origin, such as the following:
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Hematuria, in cases of bladder tumor
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Abdominal pain with or without obstruction, with small or large bowel involvement
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Hoarseness, with laryngeal involvement
Physical Examination
Physical findings are again limited by the organ system involved. Examples include the following:
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Prostatic enlargement
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Skin nodules, in cases of Merkel cell carcinoma
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Enlargement of regional draining lymph nodes
As with pulmonary small cell carcinoma, paraneoplastic syndromes have been described with extrapulmonary small cell carcinoma. Most common of these are hypercalcemia, syndrome of inappropriate secretion of antidiuretic hormone, and secretion of adrenocorticotropic hormone. Patients may present with symptoms and signs of excess calcium, hyponatremia, or corticosteroid excess, depending upon the severity and rate of development of endocrine abnormality.
