Abstract
IntroductionAlthough the syndrome of inappropriate antidiuretic hormone has connection with various malignant tumors, there are few reports associated with advanced gastric cancer.Case presentationWe describe the case of a 63-year-old Korean male with inappropriate antidiuretic hormone syndrome due to an ectopic antidiuretic hormone-producing advanced gastric adenocarcinoma manifested with overt serum hypo-osmolar hyponatremia and high urinary sodium concentrations. His adrenal, thyroidal, and renal functioning were normal, and the hyponatremia improved following removal of the tumor. The cancer cells were immunostained and found to be positive for the antidiuretic hormone. To our knowledge, this is the first report of an antidiuretic hormone-secreting advanced gastric adenocarcinoma associated with the syndrome of inappropriate antidiuretic hormone, showing cancer cells immunostained for the antidiuretic hormone.ConclusionsAlthough a strong relationship between gastric cancer and the syndrome of inappropriate antidiuretic hormone remains to be established, we suggest that gastric cancer could be included as a differential diagnosis of cancer that is associated with the syndrome of antidiuretic hormone.
Highlights
The syndrome of inappropriate antidiuretic hormone has connection with various malignant tumors, there are few reports associated with advanced gastric cancer.Case presentation: We describe the case of a 63-year-old Korean male with inappropriate antidiuretic hormone syndrome due to an ectopic antidiuretic hormone-producing advanced gastric adenocarcinoma manifested with overt serum hypo-osmolar hyponatremia and high urinary sodium concentrations
Conclusions: a strong relationship between gastric cancer and the syndrome of inappropriate antidiuretic hormone remains to be established, we suggest that gastric cancer could be included as a differential diagnosis of cancer that is associated with the syndrome of antidiuretic hormone
This was confirmed by 1) hypo-osmolar hyponatremia, hypouricemia, high urinary sodium concentration and concentrated urine; 2) normal adrenal, thyroid, and renal function; 3) inappropriate secretion of antidiuretic hormone (ADH) under hyponatremia; 4) positive immunostaining of the cancer cells with an anti-ADH antibody; 5) a full restoration of serum sodium concentration and ADH levels following the removal of the tumor
Summary
A strong relationship between gastric cancer and SIADH remains to be established, we suggest that gastric cancer could be included as a differential diagnosis of cancer that is associated with SIADH. Consent Written informed consent was obtained from the patient’s next-of-kin for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions All authors read and approved the final manuscript. JDH, JHN, BEJ, CHS, CSH, and PDJ participated in writing and editing the manuscript. All authors read and approved the final manuscript. Author details 1Department of Internal Medicine, Gyeongsang National University, College of Medicine, 816 Beongil 15 Jinju-daero, Jinju, South Korea. Author details 1Department of Internal Medicine, Gyeongsang National University, College of Medicine, 816 Beongil 15 Jinju-daero, Jinju, South Korea. 2Department of Pathology, Gyeongsang National University, College of Medicine, 816 Beongil 15 Jinju-daero, Jinju, South Korea. 3Institute of Health Science, Gyeongsang National University, College of Medicine, 816 Beongil 15 Jinju-daero, Jinju, South Korea
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