Extrathoracic manifestations of bronchogenic carcinoma.

The experimental manifestations of bronchogenic carcinoma are widely varied and often bizarre. Most of them, however, occur in association with malignant disease of other organs, so that they cannot be considered pathognomonic of bronchogenic carcinoma. Since these manifestations may be the initial clue to the presence of cancer of the lung, instead of the classical symptoms of cough, hemoptysis, and pain in the chest, it is important to be familiar with them if this highly fatal disease is to be diagnosed in its early stages when surgical excision is possible. Knowles and Smith4 classified the extrathoracic manifestations of bronchogenic carcinoma into five groups: metabolic, neuromuscular, connective-tissue and osseous, vascular, and hematologic. For purposes of this discussion their excellent classification will be used. Five hundred and thirty cases of bronchogenic carcinoma encountered at the Ochsner Clinic from 1950 to 1959 were reviewed in an effort to determine the incidence and types of extrapulmonary symptoms in these patients. This series has the usual age and sex distribution for cancer of the lung. There were 474 male and 56 female patients, 417 of whom were between 50 and 89 years of age, and 113 between 30 and 49 years. This discussion includes all extrathoracic manifestations in the series. In many patients symptoms originated in more than one site. For comparative purposes only the local and metastatic manifestations will be discussed.