Japanese Journal of Clinical Oncology 7:111-118 (1977)
© 1977 Foundation for Promotion of Cancer Research
case-report |
A Case of Small Cell Carcinoma of the Lung Producing ADH, ACTH, MSH and Calcitonin: Successful Treatment of Severe Hyponatremia with Furosemide and Hypertonic Saline
Endocrinology and Pathology Divisions, National Cancer Center Research Institute Tokyo, Japan
*Department of Internal Medicine, Tohoku University School of Medicine, Sendai Japan
Reprint requests: Kaoru Abe, M.D., Endocrinology Division, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104, Japan.
Received November 5, 1977; A 48-year-old man with a small cell carcinoma of the lung presented hyponatremia and was diagnosed as having the syndrome of inappropriate ADH secretion. A plasma ADH bioassay confirmed this syndrome. During the clinical course, the patient developed a hyponatremic crisis with a serum sodium of 108mEq/l. His hyponatremia was rapidly corrected by infusing furosemide in conjunction with hypertonic saline. The postmortem studies demonstrated ADH bioactivity in the tumor tissues, as well as immunoreactive ACTH, ß-MSH and calcitonin. Tumor hypersecretion of ACTH appeared to be the cause of the patient's hyperresponsiveness to exogenous ACTH and of the bilateral adrenocortical hyperplasia observed at the time of autopsy.
Therefore, this was a case of a multiple hormone-producing small cell carcinoma of the lung, in which the severe clinical manifestations of SIADH were successfully treated with furosemide and hypertonic saline.