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Kanzaki A, Kadoya M, Katayama S, Koyama H. Syndrome of inappropriate antidiuretic hormone with recurrent giant cabergoline-resistant prolactinoma. BMJ Case Rep 2023; 16:e255422. [PMID: 37770242 PMCID: PMC10546138 DOI: 10.1136/bcr-2023-255422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
A macro pituitary tumour or giant pituitary tumour is regarded as a rare causal factor in syndrome of inappropriate antidiuretic hormone (SIADH) cases. Previous reports have presented findings showing that blood flow insufficiency related to stress caused by an obstructive mass may lead to inappropriate secretion of arginine vasopressin. On the other hand, prolactin is known to influence water metabolism, and several cases of a macroprolactinoma or giant prolactinoma (PRLoma) in patients with SIADH have been reported. Nevertheless, few studies have examined such a relationship with SIADH and discussion of pathophysiological factors has been limited. The present report provides details of an elderly patient with SIADH in a chronic giant PRLoma. Of note, exacerbation of prolactin level accompanied the occurrence of SIADH. Findings obtained in this case suggest the possibility of development of SIADH in PRLoma cases due to more than only the effect of the mass.
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Affiliation(s)
- Akinori Kanzaki
- Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
- General Medicine, Hyogo Ika Daigaku Sasayama Iryo Center, Sasayama, Hyogo, Japan
| | - Manabu Kadoya
- Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
| | - Satoru Katayama
- General Medicine, Hyogo Ika Daigaku Sasayama Iryo Center, Sasayama, Hyogo, Japan
| | - Hidenori Koyama
- Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University, Nishinomiya, Hyogo, Japan
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Heidman LM, Peinetti N, Copello VA, Burnstein KL. Exploiting Dependence of Castration-Resistant Prostate Cancer on the Arginine Vasopressin Signaling Axis by Repurposing Vaptans. Mol Cancer Res 2022; 20:1295-1304. [PMID: 35503085 PMCID: PMC9357166 DOI: 10.1158/1541-7786.mcr-21-0927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/08/2021] [Accepted: 04/28/2022] [Indexed: 02/07/2023]
Abstract
Men with advanced prostate cancer are treated by androgen deprivation therapy but the disease recurs as incurable castration-resistant prostate cancer (CRPC), requiring new treatment options. We previously demonstrated that the G protein-coupled receptor (GPCR) arginine vasopressin receptor type1A (AVPR1A) is expressed in CRPC and promotes castration-resistant growth in vitro and in vivo. AVPR1A is part of a family of GPCR's including arginine vasopressin receptor type 2 (AVPR2). Interrogation of prostate cancer patient sample data revealed that coexpression of AVPR1A and AVPR2 is highly correlated with disease progression. Stimulation of AVPR2 with a selective agonist desmopressin promoted CRPC cell proliferation through cAMP/protein kinase A signaling, consistent with AVPR2 coupling to the G protein subunit alpha s. In contrast, blocking AVPR2 with a selective FDA-approved antagonist, tolvaptan, reduced cell growth. In CRPC xenografts, antagonizing AVPR2, AVPR1A, or both significantly reduced CRPC tumor growth as well as decreased on-target markers of tumor burden. Combinatorial use of AVPR1A and AVPR2 antagonists promoted apoptosis synergistically in CRPC cells. Furthermore, we found that castration-resistant cells produced AVP, the endogenous ligand for arginine vasopressin receptors, and knockout of AVP in CRPC cells significantly reduced proliferation suggesting possible AVP autocrine signaling. These data indicate that the AVP/arginine vasopressin receptor signaling axis represents a promising and clinically actionable target for CRPC. IMPLICATIONS The arginine vasopressin signaling axis in CRPC provides a therapeutic window that is targetable through repurposing safe and effective AVPR1A and AVPR2 antagonists.
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Affiliation(s)
- Laine M. Heidman
- 1Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | - Nahuel Peinetti
- 1Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | - Valeria A. Copello
- 1Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
| | - Kerry L. Burnstein
- 1Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida
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Arman T, Nelson PS. Endocrine and paracrine characteristics of neuroendocrine prostate cancer. Front Endocrinol (Lausanne) 2022; 13:1012005. [PMID: 36440195 PMCID: PMC9691667 DOI: 10.3389/fendo.2022.1012005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Prostate cancer is a common malignancy affecting men worldwide. While the vast majority of newly diagnosed prostate cancers are categorized as adenocarcinomas, a spectrum of uncommon tumor types occur including those with small cell and neuroendocrine cell features. Benign neuroendocrine cells exist in the normal prostate microenvironment, and these cells may give rise to primary neuroendocrine carcinomas. However, the more common development of neuroendocrine prostate cancer is observed after therapeutics designed to repress the signaling program regulated by the androgen receptor which is active in the majority of localized and metastatic adenocarcinomas. Neuroendocrine tumors are identified through immunohistochemical staining for common markers including chromogranin A/B, synaptophysin and neuron specific enolase (NSE). These markers are also common to neuroendocrine tumors that arise in other tissues and organs such as the gastrointestinal tract, pancreas, lung and skin. Notably, neuroendocrine prostate cancer shares biochemical features with nerve cells, particularly functions involving the secretion of a variety of peptides and proteins. These secreted factors have the potential to exert local paracrine effects, and distant endocrine effects that may modulate tumor progression, invasion, and resistance to therapy. This review discusses the spectrum of factors derived from neuroendocrine prostate cancers and their potential to influence the pathophysiology of localized and metastatic prostate cancer.
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Affiliation(s)
- Tarana Arman
- Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Peter S. Nelson
- Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA, United States
- *Correspondence: Peter S. Nelson,
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Kazama A, Saito T, Ishikawa S, Takeda K, Kobayashi K, Tanikawa T, Tomita Y. [SMALL CELL PROSTATE CANCER PRODUCING SYNDROME OF INAPPROPRIATE SECRETION OF ANTIDIURETIC HORMONE; A CASE REPORT]. Nihon Hinyokika Gakkai Zasshi 2018; 109:233-236. [PMID: 31631089 DOI: 10.5980/jpnjurol.109.233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 73-year-old man with progressive prostate cancer visited our hospital after prostate biopsy performed at another hospital. His serum PSA level was 29.02 ng/ml. CT revealed invasion of the bladder, bilateral ureters, and rectum. Otherwise, there was no evidence of metastasis. Pathological findings showed a poorly differentiated adenocarcinoma (Gleason score 4+5) and small cell carcinoma component. Two months after administering combined androgen blockade therapy, he was admitted due to severe hyponatremia caused by the inappropriate secretion of antidiuretic hormone. Furthermore, CT revealed right ureter metastasis, although the PSA levels remained low. Therefore, the patient was put on fluid restriction and sodium administration. After the patient recovered from hyponatremia, chemotherapy, including VP-16 and CDDP, was initiated. However, CT after two chemotherapy cycles revealed disease progression, with multiple bone metastases. Second-line chemotherapy, including CPT-11 and CDDP, was less effective, and the patient died 9 months after the diagnosis.
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Affiliation(s)
- Akira Kazama
- Department of Urology, Niigata Cancer Center Hospital
- Division of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences
| | | | - Shoko Ishikawa
- Department of Urology, Niigata Cancer Center Hospital
- Division of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences
| | - Keisuke Takeda
- Department of Urology, Niigata Cancer Center Hospital
- Division of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences
| | | | | | - Yoshihiko Tomita
- Division of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences
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Pure small cell recurrent prostate cancer developing syndrome of inappropriate antidiuretic hormone secretion. TUMORI JOURNAL 2017. [PMID: 28623637 DOI: 10.5301/tj.5000651] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Pure small cell neuroendocrine carcinoma of the prostate is a rare entity characterized by a poor prognosis due to early metastatic spread as well as resistance to treatment. Considering its increasing occurrence, clinicians should be aware of its aggressive behavior, the relevance of an early diagnosis, and proper management. METHODS A 71-year-old man treated with brachytherapy for localized low-risk prostate cancer developed widespread disease 7 years later with a prostate-specific antigen-negative neuroendocrine small cell phenotype. He was also diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) soon after starting chemotherapy. RESULTS A substantial radiologic and clinical response to chemotherapy was observed and the paraneoplastic SIADH was successfully treated with oral vaptan therapy. CONCLUSIONS Secondary small cell prostate carcinoma is an underestimated entity with high sensitivity to chemotherapy, although a standard treatment has not yet been defined. Moreover, oral vaptans demonstrated prompt efficacy and simple management in correcting SIADH-related hyponatremia.
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Pifano M, Garona J, Capobianco CS, Gonzalez N, Alonso DF, Ripoll GV. Peptide Agonists of Vasopressin V2 Receptor Reduce Expression of Neuroendocrine Markers and Tumor Growth in Human Lung and Prostate Tumor Cells. Front Oncol 2017; 7:11. [PMID: 28194370 PMCID: PMC5276816 DOI: 10.3389/fonc.2017.00011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/11/2017] [Indexed: 12/14/2022] Open
Abstract
Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies that express neuropeptides as synaptophysin, chromogranin A (CgA), and specific neuronal enolase (NSE), among others. Vasopressin (AVP) is a neuropeptide with an endocrine, paracrine, and autocrine effect in normal and pathological tissues. AVP receptors are present in human lung, breast, pancreatic, colorectal, and gastrointestinal tumors. While AVP V1 receptors are associated with stimulation of cellular proliferation, AVP V2 receptor (V2r) is related to antiproliferative effects. Desmopressin (dDAVP) is a synthetic analog of AVP that acts as a selective agonist for the V2r, which shows antitumor properties in breast and colorectal cancer models. Recently, we developed a derivative of dDAVP named [V4Q5]dDAVP, which presents higher antitumor effects in a breast cancer model compared to the parental compound. The goal of present work was to explore the antitumor properties of the V2r agonist dDAVP and its novel analog [V4Q5]dDAVP on aggressive human lung (NCI-H82) and prostate cancer (PC-3) cell lines with neuroendocrine (NE) characteristics. We study the presence of specific NE markers (CgA and NSE) and V2r expression in NCI-H82 and PC-3. Both cell lines express high levels of NE markers NSE and CgA but then incubation with dDAVP diminished expression levels of both markers. DDAVP and [V4Q5]dDAVP significantly reduced proliferation, doubling time, and migration in both tumor cell cultures. [V4Q5]dDAVP analog showed a higher cytostatic effect than dDAVP, on cellular proliferation in the NCI-H82 cell line. Silencing of V2r using small interfering RNA significantly attenuated the inhibitory effects of [V4Q5]dDAVP on NCI-H82 cell proliferation. We, preliminarily, explored the in vivo effect of dDAVP and [V4Q5]dDAVP on NCI-H82 small cell lung cancer xenografts. Treated tumors (0.3 μg kg-1, thrice a week) grew slower in comparison to vehicle-treated animals. In this work, we demonstrated that the specific agonists of V2r, dDAVP, and [V4Q5]dDAVP displays antitumor capacity on different human models of lung and prostate cancers with NE features, showing their potential therapeutic benefits in the treatment of these aggressive tumors.
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Affiliation(s)
- Marina Pifano
- Laboratory of Molecular Oncology, Quilmes National University , Bernal, Buenos Aires , Argentina
| | - Juan Garona
- Laboratory of Molecular Oncology, Quilmes National University , Bernal, Buenos Aires , Argentina
| | - Carla S Capobianco
- Laboratory of Molecular Oncology, Quilmes National University , Bernal, Buenos Aires , Argentina
| | - Nazareno Gonzalez
- Laboratory of Molecular Oncology, Quilmes National University , Bernal, Buenos Aires , Argentina
| | - Daniel F Alonso
- Laboratory of Molecular Oncology, Quilmes National University , Bernal, Buenos Aires , Argentina
| | - Giselle V Ripoll
- Laboratory of Molecular Oncology, Quilmes National University , Bernal, Buenos Aires , Argentina
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Feghaly J, Astras G. Diagnosis and management of isolated pituitary metastasis from adenocarcinoma of unknown origin presenting as loss of libido. BMJ Case Rep 2015; 2015:bcr-2014-208735. [PMID: 25827917 DOI: 10.1136/bcr-2014-208735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pituitary gland metastasis from primary tumours is uncommon on its own. Rarely, some of these primary tumours may be of unknown origin. This metastasis to the pituitary gland could manifest as diabetes insipidus, cranial nerve palsies, headaches, fatigue and other symptoms. In rare cases, it could present as loss of libido. We describe here this rare presentation, loss of libido, examine the diagnosis and management undertaken, and provide a systematic review of the literature for similar cases.
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Affiliation(s)
- Julien Feghaly
- St George's University of London, Cyprus, Nicosia, Cyprus
| | - George Astras
- Department of Oncology, American Medical Center, Nicosia, Cyprus
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Hwang K, Jeon DH, Jang HN, Bae EJ, Lee JS, Cho HS, Chang SH, Park DJ. Inappropriate antidiuretic hormone syndrome presenting as ectopic antidiuretic hormone-secreting gastric adenocarcinoma: a case report. J Med Case Rep 2014; 8:185. [PMID: 24923603 PMCID: PMC4088921 DOI: 10.1186/1752-1947-8-185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 03/26/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Although 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. 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. CONCLUSIONS Although 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.
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Affiliation(s)
| | | | | | | | | | | | | | - Dong Jun Park
- Department of Internal Medicine, Gyeongsang National University, College of Medicine, 816 Beongil 15 Jinju-daero, Jinju, South Korea.
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Hong MK, Kong J, Namdarian B, Longano A, Grummet J, Hovens CM, Costello AJ, Corcoran NM. Paraneoplastic syndromes in prostate cancer. Nat Rev Urol 2010; 7:681-92. [DOI: 10.1038/nrurol.2010.186] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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10
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Zhong M, Boseman ML, Millena AC, Khan SA. Oxytocin induces the migration of prostate cancer cells: involvement of the Gi-coupled signaling pathway. Mol Cancer Res 2010; 8:1164-72. [PMID: 20663860 DOI: 10.1158/1541-7786.mcr-09-0329] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Expression of genes that encode oxytocin (OXT) and vasopressin (AVP) and their cognate receptors in normal and diseased prostates are only partially characterized. Reverse transcription and PCR were used to examine the expression of these genes in normal prostate epithelial and stromal cell lines, k-ras-transformed prostate epithelial cell lines, and in four prostate cancer cell lines. Secreted and cell-associated OXT peptide was measured by an enzyme immunoassay. OXT and its receptor (OXTR) were expressed in all eight prostate cell lines. Cell-associated OXT peptide was also found in all prostate epithelial cell lines except in DU145 cells. Neither AVP nor its cognate receptors (V1a receptor and V2 receptor) were expressed in any prostate cell line examined. These data point to the OXTR as the primary target of OXT and AVP, and suggest that OXT might be an autocrine/paracrine regulator in human prostate. We found that OXT induces the migration of PC3 and PC3M, but not DU145 prostate cancer cells. The effect of OXT is distinct from the epidermal growth factor (EGF)-induced migration of prostate cancer cells, in which ERK1/2 and EGF receptor kinase activities were required. When cells were pretreated with pertussis toxin, the effect of OXT, but not EGF, on cell migration was abolished. Pretreatment with the cyclic AMP analogue, 8-Br-cAMP, did not affect OXT-induced cell migration, which eliminated the nonspecific effect of pertussis toxin. We conclude that a Gi-dependent mechanism is involved in OXTR-mediated migration of prostate cancer cells, and indicates a role for OXTR in prostate cancer metastasis.
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Affiliation(s)
- Miao Zhong
- Center for Cancer Research and Therapeutic Development, Clark Atlanta University, Atlanta, GA 30314, USA
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Pérez-Llantada Amunarriz E, Acha Salazar Y O, Tejido García R. [The syndrome of inappropriate secretion of antidiuretic hormone and prostate cancer: an very uncommon association]. Rev Clin Esp 2010; 210:200-1. [PMID: 20334858 DOI: 10.1016/j.rce.2009.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 06/22/2009] [Accepted: 07/06/2009] [Indexed: 01/17/2023]
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12
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Nattero L, Luque-Ramírez M, Azcárate A, Marazuela M. Recurrent hyponatremia as the presenting feature of a pituitary abscess: A case report. ACTA ACUST UNITED AC 2010; 57:123-5. [DOI: 10.1016/j.endonu.2010.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 01/15/2010] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
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Syndrome of Inappropriate Antidiuretic Hormone Secretion as an Initial Presentation of Prostate Cancer. ACTA ACUST UNITED AC 2009. [DOI: 10.1097/ten.0b013e3181aeda1f] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee KS, Kang TW, Ma SK, Kim SW, Kim NH, Choi KC. SIADH associated with prostate cancer. Electrolyte Blood Press 2007; 5:47-9. [PMID: 24459500 PMCID: PMC3894506 DOI: 10.5049/ebp.2007.5.1.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Accepted: 05/10/2007] [Indexed: 11/07/2022] Open
Abstract
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common disease leading to hyponatremia, and it is characterized by an inappropriately elevated serum ADH level relative to serum osmolality. This syndrome may occur in a variety of clinical settings including malignancies. However, it is rarely observed in association with prostate cancer. Moreover, its pathogenesis and clinical characteristics have not been completely understood. We report a case of SIADH associated with prostate cancer in a 64-year-old male patient with a literature review.
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Affiliation(s)
- Kyun Sang Lee
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Taek Won Kang
- Department of Urology, Chonnam National University Medical School, Gwangju, Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Nam Ho Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ki Chul Choi
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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Ihara C, Nakamoto Y, Nakatsuru Y, Yano J, Sakamoto S, Nanno M, Koshiyama H. Usefulness of FDG-PET in detecting an ADH-secreting tumor: a case report. Eur J Intern Med 2004; 15:181-182. [PMID: 15245722 DOI: 10.1016/j.ejim.2004.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2003] [Revised: 08/25/2003] [Accepted: 08/26/2003] [Indexed: 11/28/2022]
Abstract
We report a case of a 41-year-old woman who was diagnosed as having the syndrome of inappropriate secretion of ADH (SIADH). There was no evidence of any disorders of the central nervous system, lung diseases, or drugs causing SIADH. Positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) was performed and indicated a tumor of the uterine cervix. After resection of the tumor, both serum sodium level and serum osmolarity were normalized concomitantly with a decrease in serum ADH level. This is the first case report suggesting the usefulness of a FDG-PET scan to detect an occult cancer responsible for SIADH. It seems plausible that FDG-PET may be helpful in the diagnosis of other ectopic hormone-producing tumors such as ectopic ACTH-producing tumors that cause Cushing's syndrome.
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Affiliation(s)
- Chiro Ihara
- Division of Diabetes & Endocrinology, Department of Internal Medicine, Tazuke Kofukai Foundation Medical Research Institute Kitano Hospital, Osaka 530-8480, Japan
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Ars C, Duck L, Baurain JF, Moulin P, Duprez T, Machiels JP. Unusual metastatic features in a patient with concomitant malignant orbital melanoma and prostate carcinoma. J Neurooncol 2004; 66:361-3. [PMID: 15015669 DOI: 10.1023/b:neon.0000014540.05737.1a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A 73-year-old man with a history of malignant orbital melanoma and prostate carcinoma was admitted for progressive visual disturbance. Brain magnetic resonance imaging showed a suprasellar enhancing nodular lesion with major impingement on the anterior optical ways and sellar invasion. The extensive imaging work-up could not demonstrate with certainty its origin. Surprisingly, the transphenoidal biopsy of this patient revealed a prostate cancer metastasis outlining the importance of a histopathological diagnosis of cerebral metastases in patients with multiple malignancies when there is a doubt about the nature of the lesion.
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Affiliation(s)
- Catherine Ars
- Medical Oncology Unit, Centre du Cancer, Université Catholique de Louvain, Brussels, Belgium
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