ABSTRACT
La hiponatremia es la alteración electrolítica más frecuente en el medio hospitalario, y en un 30% de los casos se debe a un síndrome de secreción inapropiada de vasopresina (SIADH). El SIADH está descrito como cuadro paraneoplásico endocrinológico en múltiples tumores, entre los que excepcionalmente se encuentra el de ovario y las neoplasias ginecológicas en general. Presentamos un caso de SIADH paraneoplásico por un citoadenocarcinoma seroso de ovario de alto grado, estadio IV. Se trata del primer caso de SIADH crónico por cáncer de ovario tratado con Tolvaptán. En el presente caso el objetivo de eunatremia se alcanzó con una dosis baja de acuarético, lo que apoya la elevada sensibilidad, ya previamente documentada, de los SIADH tumorales al tratamiento con Tolvaptán.
Hyponatremia is the most common electrolyte disturbance in hospitals, and 30% of cases are due to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). SIADH is described as an endocrine paraneoplastic syndrome in multiple tumors including, ovary and gynecological malignancies in general, although these are exceptional. We report a case of paraneoplastic SIADH for high-grade serous ovarian cystoadenocarcinoma stage IV. This is the first case of chronic SIADH for ovarian cancer treated with Tolvaptan. In this case the target of eunatremia was reached with a low dose of aquaretic, which supports the high sensitivity, as previously documented, of paraneoplasic SIADH to Tolvaptan.
Subject(s)
Humans , Female , Adult , Benzazepines/therapeutic use , Hyponatremia/drug therapy , Inappropriate ADH Syndrome/complications , Inappropriate ADH Syndrome/drug therapy , Antidiuretic Hormone Receptor Antagonists/therapeutic use , Cystadenocarcinoma, Serous/complications , Hyponatremia/etiology , Ovarian Neoplasms/complicationsABSTRACT
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) may be observed in various types of cancer, but is mainly seen in small-cell carcinoma. It can also be caused by several chemotherapeutic agents. However, it is a very rare phenomenon in esophageal cancer or its treatment. We report here on a case of SIADH related to esophageal cancer treatment. A 55-year-old man received chemoradiotherapy (CRT) for esophageal cancer. After receiving CRT for 5 days, he complained of nausea, dizziness, and general weakness, and his sodium level had dropped to 107 mEq/L. His volume status was clinically euvolemic and there were no edema or pigmentation. After hypertonic saline infusion, the sodium level increased and the symptoms improved. There have been several reports of SIADH associated with malignancies or chemotherapy agents. However, to the best of our knowledge, this is the first Korean case of SIADH associated with esophageal cancer that occurred after cisplatin treatment.