Journal article
Syndrome of inappropriate antidiuretic hormone secretion in a patient with cryptococcal meningoencephalitis : A hidden mediastinal small cell carcinoma
The American journal of the medical sciences, Vol.331(5), pp.288-291
05/01/2006
DOI: 10.1097/00000441-200605000-00012
PMID: 16702802
Abstract
We report a 59-year-old man with cryptococcal meningoencephalitis who presented with typical features of syndrome of inappropriate antidiuretic hormone secretion (SIADH). There was no evidence of lung disease or drugs causing SIADH. Studies for endocrine functions and tumor markers were normal. The patient's hyponatremia was refractory to treatment (Na 120-125 mmol/L) after resolution of the cryptococcal infection. Three months after completion of antifungal treatment, a radiograph of the chest disclosed widening of the mediastinum. Computed tomography revealed a mediastinal mass. A tentative diagnosis of extrapulmonary cryptococcoma or a tumor was made. Positron emission tomography using F-fluorodeoxy glucose demonstrated an intense uptake mass in the mediastinum without lesions elsewhere in the body. A biopsy of the mass clearly showed small cell carcinoma (SCC) with positive immunoreactivity for arginine vasopressin and atrial natriuretic peptide. The hyponatremia completely resolved and tumor size dramatically decreased after chemotherapy. To the best of our knowledge, this is the first case of mediastinal SCC associated with SIADH. Patients with otherwise unexplained SIADH should be meticulously scrutinized for a possible malignancy. Copyright © by the Southern Society for Clinical Investigation.
Details
- Title: Subtitle
- Syndrome of inappropriate antidiuretic hormone secretion in a patient with cryptococcal meningoencephalitis : A hidden mediastinal small cell carcinoma
- Creators
- Chan-Chih Yang - Tri-Service General HospitalHerng-Sheng Lee - Tri-Service General HospitalChun-Chi Chen - Tri-Service General HospitalChih-Jen Cheng - Tri-Service General HospitalShih-Hua Lin - Tri-Service General Hospital
- Resource Type
- Journal article
- Publication Details
- The American journal of the medical sciences, Vol.331(5), pp.288-291
- Publisher
- Lippincott
- DOI
- 10.1097/00000441-200605000-00012
- PMID
- 16702802
- ISSN
- 0002-9629
- eISSN
- 1538-2990
- Language
- English
- Date published
- 05/01/2006
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984383886402771
Metrics
12 Record Views