Shaheen Khaldoon, Alraiyes Abdul Hamid, Baibars Motaz, Eisa Naseem, Alraies M Chadi
Department of Hospital Medicine, Institute of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Pulmonary Diseases, Critical Care, and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
N Am J Med Sci. 2013 Nov;5(11):660-2. doi: 10.4103/1947-2714.122310.
The key clinical features in this case are to make the diagnosis apical lung cancer (Pancoast tumor) in a patient with brachial plexopathy and to recognize the association between syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a paraneoplastic syndrome and non-small cell lung cancer (NSCLC).
We herein describe a rare case of NSCLC presented as pancoast tumor complicated by brachial plexopathy and associated with SIADH as a paraneoplastic phenomena. There were no renal insufficiency, congestive cardiac failure, liver insufficiency, volume depletion, diuretic use, hypoadrenalism, and hypothyroidism in our patient. Furthermore, the findings of serum hyponatraemia and hypo-osmolality associated with an inappropriate high urinary osmolality indicate that the SIADH was present in our patient due to the NSCLC.
Our case also emphasizes that early recognition and appropriate applied management may significantly improve symptoms and prevent complications of hyponatremia which may enhance quality of life in patients with paraneoplastic SIADH.
该病例的关键临床特征是在一名患有臂丛神经病变的患者中诊断出肺尖癌（潘科斯特瘤），并认识到抗利尿激素分泌不当综合征（SIADH）作为一种副肿瘤综合征与非小细胞肺癌（NSCLC）之间的关联。
我们在此描述了一例罕见的NSCLC病例，表现为潘科斯特瘤，并发臂丛神经病变，并伴有SIADH作为副肿瘤现象。我们的患者没有肾功能不全、充血性心力衰竭、肝功能不全、容量耗竭、使用利尿剂、肾上腺功能减退和甲状腺功能减退。此外，血清低钠血症和低渗透压伴尿渗透压不适当升高的结果表明，我们的患者因NSCLC而存在SIADH。
我们的病例还强调，早期识别和适当的应用管理可能会显著改善症状并预防低钠血症的并发症，这可能会提高副肿瘤性SIADH患者的生活质量。
