Tamura Tetsuo, Takeuchi Kazuo
Gastroenterological Department, Toranomon Hospital, Tokyo, Japan.
BMJ Case Rep. 2013 Jun 11;2013:bcr2013010039. doi: 10.1136/bcr-2013-010039.
Small cell gall bladder carcinoma (Scc-GB) is a very rare entity. Although some cases present with endocrine manifestations, paraneoplastic hyponatraemia has been reported in only one previous case. Recently, the antidiuretic hormone (ADH) receptor antagonist mozavaptan has become available. Herein we report a case with Scc-GB complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) treated with mozavaptan. A 47-year-old woman was referred to our hospital for hyponatraemia. Physical examination revealed elevated serum ADH, a gall bladder mass. She was clinically diagnosed with Scc-GB with SIADH as a paraneoplastic syndrome. Mozavaptan was used for SIADH. Serum sodium was quickly normalised after mozavaptan treatment. Two months later, metastasis to the subcutis of the abdominal wall was observed. The metastatic nodule was resected, and small cell carcinoma (Scc) was identified pathologically. Mozavaptan was effective for improvement of hyponatraemia in this patient with Scc-GB complicated with SIADH.
小细胞胆囊癌(Scc-GB)是一种非常罕见的疾病。尽管有些病例表现出内分泌症状,但此前仅有一例报道过副肿瘤性低钠血症。最近,抗利尿激素(ADH)受体拮抗剂莫扎伐普坦已可供使用。在此,我们报告一例小细胞胆囊癌合并抗利尿激素分泌不当综合征(SIADH)并接受莫扎伐普坦治疗的病例。一名47岁女性因低钠血症被转诊至我院。体格检查发现血清抗利尿激素升高及胆囊肿块。她被临床诊断为小细胞胆囊癌合并SIADH作为副肿瘤综合征。使用莫扎伐普坦治疗SIADH。莫扎伐普坦治疗后血清钠迅速恢复正常。两个月后,观察到腹壁皮下转移。切除转移结节,病理检查确诊为小细胞癌(Scc)。莫扎伐普坦对改善该例合并SIADH的小细胞胆囊癌患者的低钠血症有效。