Department of Endocrinology, Farhat Hached Hospital, Sousse, Tunisia.
Department of anatomic pathology, Farhat Hached Hospital, Sousse, Tunisia.
Tunis Med. 2023 Aug-Sep;101(8-9):715-717.
Hyponatremia is the most common fluid electrolyte disorder in hospitalized patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the main cause of normovolemic hyponatremia, it can be caused by diverse etiologies: malignant tumors are the most feared cause that clinician persists in finding. Exceptionally, SIADH can complicate Esthesioneuroblastoma (ENB) or olfactory neuroblastoma, a rare tumor of the nasal sinus cavities. We report the case of a 26-year-old female patient admitted for recurrent headaches and vomiting, with a profound normovolemic hyponatremia at the initial assessment. Biological explorations have concluded in a SIADH. Imaging showed a mass of the left nasal cavity with extensions to the ipsilateral paranasal sinuses. The biopsy of the lesion, under endoscopic control, was inconclusive. The anatomopathological study, after surgical removal, concluded in ENB. The postoperative evolution was marked by the normalization of the natremia.
低钠血症是住院患者中最常见的液体电解质紊乱。抗利尿激素分泌不当综合征(SIADH)是等容量性低钠血症的主要原因,它可由多种病因引起:恶性肿瘤是临床医生最担心的原因。但罕见情况下,SIADH 可并发鼻腔神经鞘瘤(ENB)或嗅神经母细胞瘤,这是一种鼻窦腔的罕见肿瘤。我们报告了一例 26 岁女性患者,因反复发作性头痛和呕吐入院,最初评估时存在严重的等容量性低钠血症。生物学检查结果提示 SIADH。影像学检查显示左侧鼻腔有肿块,向同侧副鼻窦延伸。在鼻内镜控制下对病变进行活检,结果不确定。手术切除后的解剖病理学研究结果提示为 ENB。术后,血钠恢复正常。