Introduction: This study was aimed at reviewing useful criteria for the diagnosis of fever of paraneoplastic origin in patients with cancer.
Current knowledge and key points: Apart from episodes of neutropenia, hyperthermia is observed in approximately 60% of patients with cancer. Fever is often due to infection and, as a contraindication, may hamper treatment. The differential diagnosis, i.e., fever of paraneoplastic or infectious origin, may be difficult. Paraneoplastic fever is mostly observed in patients with advanced cancer. It is related to the production of inflammatory cytokines, especially interleukin 6, and is not specific. Neither current markers of inflammation, nor X-ray, nor naproxen confirm diagnosis. The diagnosis of fever of paraneoplastic origin in patients with cancer should rely on a network of arguments to exclude other causes of fever, especially infectious causes.
Future and projects: Further evaluation of the specificity of procalcitonin will determine whether or not it is a useful tool for the diagnosis of fever of paraneoplastic or infectious origin.