Yonsei Med J.  2012 May;53(3):667-669. 10.3349/ymj.2012.53.3.667.

Syndrome of Inappropriate Antidiuretic Hormone Secretion in a Patient with Large Cell Neuroendocrine Carcinoma

• Oh HJ
• Lee MJ
• Jang SJ
• Shin DH
• Kang SW

• KMID: 1777007
• DOI: http://doi.org/10.3349/ymj.2012.53.3.667

Abstract

The syndrome of inappropriate antidiuretic hormone secretion has only been reported in a few patients with large cell neuroendocrine carcinoma (LCNEC); however, it has never been reported in a patient with LCNEC of the lung, whose serum sodium levels were normalized after surgical resection of the mass. A 63-year-old male presented with a two-day history of dizziness and recent memory loss. On admission, his serum sodium level was 113 mEq/L with a serum osmolality of 236 mosm/kg, a urine osmolality of 441 mosm/kg, and a urine sodium level of 65 mEq/L. His chest computed tomography revealed a 2.7x2.3 cm-sized mass in the left lower lobe. After surgical removal of the mass, his serum sodium concentrations were normalized, and histopathology of the mass revealed LCNEC.

Keyword

Hyponatremia; syndrome of inappropriate antidiuresis; large cell neuroendocrine carcinoma

MeSH Terms

Carcinoma, Large Cell/*pathology
Carcinoma, Neuroendocrine/*pathology
Humans
Inappropriate ADH Syndrome/*pathology
Male
Middle Aged

Figure

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  Fig. 1 Chest computed tomography revealed a 2.7×2.3 cm-sized well-defined lobulated mass in the superior segment of the left lower lobe, abutting on the parietal pleura.

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  Fig. 2 Immunohistochemical staining showed diffusely strong staining for synaptophysin (A) and Ki-67 (B).

Reference

1. Schwartz WB, Bennett W, Curelop S, Bartter FC. A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. 1957. J Am Soc Nephrol. 2001. 12:2860–2870.

2. List AF, Hainsworth JD, Davis BW, Hande KR, Greco FA, Johnson DH. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in small-cell lung cancer. J Clin Oncol. 1986. 4:1191–1198.

3. Bartter FC, Schwartz WB. The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med. 1967. 42:790–806.

4. Brambilla E, Travis WD, Colby TV, Corrin B, Shimosato Y. The new World Health Organization classification of lung tumours. Eur Respir J. 2001. 18:1059–1068.

5. Asamura H, Kameya T, Matsuno Y, Noguchi M, Tada H, Ishikawa Y, et al. Neuroendocrine neoplasms of the lung: a prognostic spectrum. J Clin Oncol. 2006. 24:70–76.

6. Takei H, Asamura H, Maeshima A, Suzuki K, Kondo H, Niki T, et al. Large cell neuroendocrine carcinoma of the lung: a clinicopathologic study of eighty-seven cases. J Thorac Cardiovasc Surg. 2002. 124:285–292.

7. Johnson BE, Chute JP, Rushin J, Williams J, Le PT, Venzon D, et al. A prospective study of patients with lung cancer and hyponatremia of malignancy. Am J Respir Crit Care Med. 1997. 156:1669–1678.

8. Agarwala SS. Paraneoplastic syndromes. Med Clin North Am. 1996. 80:173–184.