An occult malignancy may present in a myriad of different ways. Any unexplained sign or symptom could be related to an occult malignancy. How far to work-up a patient with any of these findings is often a difficult question to answer.
Metastatic cancer:
(1) pathologic fracture from an osseous metastasis
(2) headache or altered mental status from meningeal or intracranial mass
(3) constrictive pericarditis
(4) cutaneous
(5) liver failure
(6) sudden hearing loss
(7) lymphadenopathy
Thromboembolic or vascular:
(1) venous thrombosis
(2) arterial thrombosis
(3) Raynaud's phenomenon
(4) pulmonary emboli
(5) ischemic stroke
Endocrine or Metabolic:
(1) hypercalcemia
(2) hyperuricemia (spontaneous tumor lysis syndrome)
(3) SIADH
(4) hypercorticolism
(5) hypoglycemia
Other paraneoplastic syndrome:
(1) dermatomyositis
(2) neurologic (Bell's palsy, demyelination, cerebellar, encephalitis, neuropathy)
(3) skin lesions (pemphigus, hypertrichosis, acanthosis nigricans, livedo reticularis, pruritis, scleroderma
(4) migrating polyarthritis
(5) change in vision
Infection:
(1) pneumonia
(2) sepsis
(3) Herpes zoster
Other:
(1) nipple discharge
(2) unexplained weight loss
(3) pain
(4) diarrhea
(5) glomerulopathy
(6) bowel obstruction
(7) fever of unknown origin (FUO)
