The authors present the case of a 51-year-old female with a syndrome of inappropriate secretion of antidiuretic hormone (SIADH) due to a malignant thymoma. Laboratory examinations of the patient showed hyponatremia, plasma hypoosmolarity in the presence of concentrated urine and normal urine excretion of sodium. CT revealed a mass lesion in the mediastinum. A biopsy of the mediastinal mass was performed and the diagnosis of thymoma with SIADH was established. This is a rare description of a malignant thymoma associated with SIADH.

Keywords:
Syndrome of inappropriate secretion of antidiuretic hormone, Malignant thymoma
1.
Almong C, Horowitz M, Burke M: Steroid therapy in inappropriate secretion of antidiuretic hormone due to malignant thymoma. Respiration 1983;44:382–386.
2.
Levin L, Sealy R, Barron J: Syndrome of inappropriate antidiuretic hormone secretion following dis-dichlorodiammineplatinum II in a patient with malignant thymoma. Cancer 1982;50:2279–2282.
3.
Otsuka F, Hayashi Y, Ogura T, Hayakawa N, Ikeda S, Makino H, Ota Z: Syndrome of inappropriate antidiuretic hormone secretion following intra-thoracic cisplatin. Intern Med 1996;35:290–294.
4.
Asada Y, Marutsuka K, Mitsukawa T, Kuribayashi T, Taniguchi S, Sumiyoshi A: Ganglioneuroblastoma of the thymus: An adult case with the syndrome of inappropriate secretion of antidiuretic hormone. Hum Pathol 1996;27:506–509.
5.
Donadio AC, Dragnev KH, Schwartz GK: Thymoma associated with syndrome of inappropriate antidiuretic hormone secretion and myastenia gravis. South Med J 1998;91:278–279.
6.
Imura H, Matsukura S, Yamamoto H, et al: Studies on ectopic ACTH-producing tumors. II. Clinical and biochemical features of 30 cases. Cancer 1975;35:1430–1437.
7.
Winkler AW, Cranshaw OS: Chloride depletion conditions other than Addison’s disease. J Clin Invest 1938;17:1–6.
8.
Schwartz WB, Bennett W, Curelop S, Bartter FC: A syndrome of renal loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Am J Med 1957;23:529–542.
9.
Leaf A, Bartter FC, Santos RF, Wrong O: Evidence in man that urinary electrolytes loss induced by pitressin is a function of water retention. J Clin Invest 1953;32:868–878.
10.
Thorn NA, Transbol I: Hyponatremia and bronchogenic carcinoma associated with renal excretion of large amounts of antidiuretic material. Am J Med 1963;35:257–263.
11.
Amatruda TT, Mulrow PJ, Gallanger JC, Sawyer WH: Carcinoma of the lung with inappropriate antidiuresis: Demonstration of antidiuretic-hormone-like activity in tumor extract. N Engl J Med 1963;269:544–549.
12.
Moses AM, Miller M, Streeton DHP: Pathophysiologic and pharmacologic alterations in the release and action of ADH. Metabolism 1976;25:697–721.
13.
De Troyer A, Demanet JC: Clinical, biological and pathogenic features of the syndrome of inappropriate secretion of antidiuretic hormone: A review of 26 cases with marked hyponatremia. Q J Med 1976;45:521–531.
14.
Bartter FC, Schwartz WB: The syndrome of inappropriate secretion of antidiuretic hormone. Am J Med 1967;42:790–806.
15.
Vorherr H: Para-endocrine tumor activity with emphasis on ectopic ADH secretion. Genetic, diagnostic, prognostic and therapeutic aspects. Oncology 1974;29:382–386.
16.
Gschwantler M, Weiss W: Hyponatremic coma as the first symptom of a small cell bronchial carcinoma (in German). Dtsch Med Wochenschr 1994;119:261–264.
17.
Coyle S, Penney MD, Masters PW, Walker BE: Early diagnosis of ectopic arginine vasopressin secretion. Clin Chem 1993;39:152–154.
© 2002 S. Karger AG, Basel
2002
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