Maeda Koki, Mori Yuri, Nakamura Masatoshi, Harada Yoshimasa, Kodama Kenichi
The Department of Urology, Nagahama Red Cross Hospital.
The Department of Diabetes and Endocrinology, Nagahama Red Cross Hospital.
Nihon Hinyokika Gakkai Zasshi. 2021;112(2):100-104. doi: 10.5980/jpnjurol.112.100.
A 54-year-old woman was admitted to our hospital complaining of gross hematuria and difficulty urinating. Cystoscopy revealed a tumor 4 cm in size with calcification on top of the bladder. After diagnosis of urachal carcinoma by transurethral resection of the bladder, partial cystectomy with en bloc resection of the median umbilical ligament and pelvic lymphadenectomy was performed. Pathological diagnosis confirmed urachal carcinoma, pT3b, ly1, v0, pN1, RM0. TS-1 and cisplatin chemotherapy (TS-1 at 100 mg/day on days 1-21, CDDP at 60 mg/m on day 8) was administered. On day 13, the patient was admitted because of consciousness disorder (Glasgow Coma Scale E2V1M4). Hyponatremia (Na 109 mEq/l) and renal excretion of sodium were present and the patient was diagnosed with the syndrome of inappropriate antidiuretic hormone secretion (SIADH) induced by chemotherapy. Serum sodium level and her consciousness level gradually improved after administration of 3% saline. SIADH caused by chemotherapy containing cisplatin is a relatively rare, but potentially serious adverse effect that requires close attention.
一名54岁女性因肉眼血尿和排尿困难入院。膀胱镜检查发现膀胱顶部有一个4厘米大小且伴有钙化的肿瘤。经尿道膀胱肿瘤切除术后诊断为脐尿管癌，遂行膀胱部分切除术，同时整块切除脐正中韧带并进行盆腔淋巴结清扫术。病理诊断确诊为脐尿管癌，pT3b，ly1，v0，pN1，RM0。给予替吉奥（TS-1）和顺铂化疗（TS-1 100毫克/天，第1 - 21天；顺铂60毫克/平方米，第8天）。第13天，患者因意识障碍（格拉斯哥昏迷评分E2V1M4）入院。存在低钠血症（血钠109毫当量/升）及肾性失钠，患者被诊断为化疗诱发的抗利尿激素分泌异常综合征（SIADH）。给予3%盐水后血钠水平和意识水平逐渐改善。含顺铂化疗引起的SIADH是一种相对罕见但可能严重的不良反应，需要密切关注。
