嗅神经母细胞瘤患者抗利尿激素分泌不当综合征。
Syndrome of inappropriate antidiuretic hormone secretion in patients with olfactory neuroblastoma.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts 02114, USA.
出版信息
Otolaryngol Head Neck Surg. 2012 Jul;147(1):147-51. doi: 10.1177/0194599812438842. Epub 2012 Feb 24.
OBJECTIVE
The syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been reported as a paraneoplastic syndrome in many different types of malignancies. Several case reports of SIADH have been reported in patients with olfactory neuroblastoma (ONB), but the exact incidence is unknown. The purpose of this study was to review our experience with olfactory neuroblastoma and to identify all patients who had a history of SIADH prior to the diagnosis of ONB.
STUDY DESIGN
Case series and chart review.
SETTING
Tertiary care university-affiliated medical center.
SUBJECTS AND METHODS
A total of 21 patients presented to our institution with ONB between 1997 and 2009. All records were reviewed for a history of preoperative hyponatremia or SIADH.
RESULTS
Three patients were identified who had a history of SIADH prior to the diagnosis of ONB. Immunohistochemical staining of the tumor specimens from the 3 patients with SIADH was positive for arginine vasopressin. SIADH resolved in all 3 patients after successful treatment of ONB.
CONCLUSION
Although uncommon, SIADH can be the presenting symptom of ONB and should be considered during the workup for idiopathic SIADH.
目的
抗利尿激素分泌不当综合征（SIADH）已在许多不同类型的恶性肿瘤中被报道为副肿瘤综合征。有几例嗅觉神经母细胞瘤（ONB）患者发生 SIADH 的病例报告，但确切的发病率尚不清楚。本研究的目的是回顾我们在嗅觉神经母细胞瘤方面的经验，并确定所有在诊断为 ONB 之前有 SIADH 病史的患者。
研究设计
病例系列和图表回顾。
设置
三级保健大学附属医院。
受试者和方法
1997 年至 2009 年间，共有 21 名患者因 ONB 就诊于我院。对所有记录进行了回顾，以了解术前低钠血症或 SIADH 的病史。
结果
在诊断为 ONB 之前，有 3 名患者有 SIADH 病史。3 例 SIADH 患者的肿瘤标本免疫组化染色均为精氨酸加压素阳性。ONB 成功治疗后，所有 3 例患者的 SIADH 均得到缓解。
结论
尽管不常见，但 SIADH 可作为 ONB 的首发症状，在对特发性 SIADH 进行检查时应考虑到这一点。
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