Some cancers bring masses.
Small cell lung cancer brings drama!! 😬
This tumor doesn’t just metastasize — it moonlights as an endocrine gland, a neurologist’s nightmare, and sometimes a full-blown mimic artist. 🎭 Welcome to the paraneoplastic parade of Small Oat Cell Lung Cancer (SOCLC).
🧠 Meet the Mnemonic: SOCLC
This one’s deliciously intuitive: Small Oat Cell Lung Cancer → just remember:
SOCLC = SIADH, Opsoclonus-myoclonus, Cushing, LEMS, Cerebellar degeneration
Mnemonic: Small Oat Cell Lung Cancer: Paraneoplastic Syndromes
| Letter | Paraneoplastic Syndrome | Mechanism / Key Features |
|---|---|---|
| S | SIADH | ↑ ADH → hyponatremia, low serum osmolality, confusion 🤯 |
| O | Opsoclonus-myoclonus | Rare neuro syndrome; chaotic eye movements + involuntary jerks 👀 |
| C | Cushing syndrome | Ectopic ACTH → central obesity, moon face, hyperglycemia 🍩 |
| L | LEMS (Lambert-Eaton Myasthenic Syndrome) | Autoantibodies vs presynaptic Ca²⁺ channels → proximal weakness 💪 |
| C | Cerebellar degeneration (anti-Hu Abs) | Gait ataxia, dysarthria, intention tremor — slow neuro meltdown 🧠 |
🏥 Clinical Insights from Quetta
I still remember the 55-year-old gentleman we admitted to the CCU at Sheikh Khalifa Bin Zayed Hospital, presenting with muscle weakness and a sodium level that would terrify any nephrologist. Turns out he had hyponatremia, proximal muscle weakness, and later developed cerebellar signs.
- CT chest? A shady hilar mass.
- Biopsy? Small cell lung cancer.
- Antibodies? Anti-Hu positive.
- Diagnosis? A full-blown paraneoplastic performance from the SOCLC script. 🎬
🩺 USMLE & Ward Wisdom
- SIADH shows up as euvolemic hyponatremia. Key: low serum osmolality, high urine Na⁺
- Cushing syndrome here is ACTH-dependent → skin changes, immunosuppression, psychiatric symptoms
- LEMS improves with activity (unlike MG). Reflexes may return after exertion — weird but classic
- Cerebellar degeneration often precedes tumor diagnosis. The brain knows before the scan does.
Happy learning, folks!
📚 Written by:
Dr. Aurangzaib Qambrani
MBBS, PLAB, MRCP-UK
General Medicine, Gastroenterology & CCU
Sheikh Khalifa Bin Zayed Hospital, Quetta
