128PARANEOPLASTIC SYNDROME: A CASE STUDYParaneoplastic syndrome are rare disorders that are triggered by an altered immune system response to a neoplasm. These disorders arise from tumour secretion of hormones, peptides, or cytokines or from immune cross-reactivity between malignant and normal tissues. Paraneoplastic syndromes may affect diverse organ systems, most notably the endocrine, neurologic, dermatologic, rheumatologic, and hematologic systems. Treatments include addressing the underlying malignancy, immunosuppression (for neurologic, dermatologic, and rheumatologic paraneoplastic syndromes), and correction of electrolyte and hormonal derangements (for endocrine paraneoplastic syndromes). We are reporting a case of male patient who presented with skin lesion, lower limb edema and clawing of hands.On investigation, the patient showed a positive sign of adrenal carcinoma and specific tests were performed and discharged with certain corresponding medications and topical agents.Sujithmvnair85@gmail.comcasereport822018Paraneoplastic syndrome, Clawing of hands, adrenal carcinoma, skin lesion, mononeuropathy multiplex.Sujith M,Zachariah Thomas,Aparna Jayadevi Rajendran,Remya Soman,Sajila Sylus,Sivalekshmi S.PSujith M,Zachariah Thomas,Aparna Jayadevi Rajendran,Remya Soman,Sajila Sylus,Sivalekshmi S.P