Ogawa Fumihiro, Amano Hideki, Iyoda Akira, Satoh Yukitoshi
Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Interact Cardiovasc Thorac Surg. 2009 Nov;9(5):903-5. doi: 10.1510/icvts.2009.210229. Epub 2009 Aug 6.
We describe a rare case of thymic neuroblastoma with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A 60-year-old male patient was admitted to our hospital for further examination and treatment of anterior mediastinal tumor found at a regular health check-up. On examination there was hyponatremia, decrease in plasma osmolarity and elevation of plasma antidiuretic hormone (ADH) level. Thus, he underwent total thymectomy under the diagnosis of thymoma with SIADH. The tumor was located in the right lobe of the thymus and the final diagnosis was thymic neuroblastoma. To our knowledge, this is the first reported case of thymic neuroblastoma in which production of ADH by tumor cells is demonstrated immunohistochemically. This case highlights the need to consider functional activity of thymic neuroblastoma and complete resection of the tumor is warranted for treatment.
我们描述了一例罕见的伴有抗利尿激素不适当分泌综合征(SIADH)的胸腺神经母细胞瘤。一名60岁男性患者因在定期健康检查中发现前纵隔肿瘤而入院接受进一步检查和治疗。检查发现有低钠血症、血浆渗透压降低和血浆抗利尿激素(ADH)水平升高。因此,他在被诊断为胸腺肿瘤伴SIADH后接受了全胸腺切除术。肿瘤位于胸腺右叶,最终诊断为胸腺神经母细胞瘤。据我们所知,这是首例经免疫组织化学证实肿瘤细胞产生ADH的胸腺神经母细胞瘤病例报告。该病例强调了需要考虑胸腺神经母细胞瘤的功能活性,并且有必要对肿瘤进行完整切除以进行治疗。