Neoplasia and Cancer Biology · USMLE Step 1

Which of the following is most likely to be a paraneoplastic syndrome rather than a direct effect of tumor mass or metastasis?

  1. Compression of adjacent structures by a lung tumor
  2. Hypercalcemia from PTHrP secreted by a squamous cell carcinoma
  3. Bone pain from skeletal metastases
  4. Biliary obstruction by a pancreatic head tumor
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Correct answer: Hypercalcemia from PTHrP secreted by a squamous cell carcinoma

Paraneoplastic syndromes are mediated by substances secreted by tumor cells (e.g., PTHrP causing hypercalcemia), not by direct mass effect or metastasis.

Difficulty: Medium Question 20 of 20

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