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Abstract：
Association of SIADH with malignancy was first reported in 1957, when it was described in two patients with bronchogenic carcinoma. While the association with small cell lung cancer (SCLC) is well known, that with non small cell lung cancer (NSCLC) has been rarely reported. We report a case of 70 year old male who was found to have hyponatremia secondary to SIADH. Radiological tests revealed right hilar lung mass with mediastinal adenopathy. Bronchoscopic biopsy revealed non-small cell lung cancer of type squamous cell. Magnetic resonance imaging (MRI) of brain showed metastatic lesions, thereby confirming diagnosis of metastatic lung cancer. Paraneoplastic syndromes occur in 10% of lung cancer cases and they represent a group of disorders related to secretion of functional polypeptides or hormones from tumor cells. SIADH is more commonly described in conjunction with small cell lung cancer but there are a few case reports describing it\'s occurrence after initiation of therapy for NSCLC such as radiation and chemotherapy. The mechanism for this phenomenon is not known. Unlike infectious causes, hyponatremia as initial presentation is an uncommon feature of malignancy-associated SIADH. In the lung cancer population, hyponatremia has been identified as a negative prognostic factor in hospitalized patients and those with advanced-stage disease. Malignancy should be a consideration in the diagnostic evaluation of SIADH, irrespective of the time of presentation.
摘要：
SIADH与恶性肿瘤的关联于1957年首次报道，当时在两名支气管癌患者中进行了描述。虽然与小细胞肺癌（SCLC）的关系是众所周知的，关于非小细胞肺癌（NSCLC）的报道很少。我们报告一例70岁的男性，被发现患有继发于SIADH的低钠血症。放射学检查显示右肺肺门肿块伴纵隔腺病。支气管镜活检显示鳞状细胞型非小细胞肺癌。脑部磁共振成像（MRI）显示转移性病变，从而确认转移性肺癌的诊断。副肿瘤综合征发生在10%的肺癌病例中,它们代表与从肿瘤细胞分泌功能性多肽或激素相关的一组病症。SIADH更常用于与小细胞肺癌结合，但有少数病例报告描述它在NSCLC开始治疗如放疗和化疗后发生。这种现象的机理尚不清楚。与传染性原因不同，低钠血症作为初始表现是恶性肿瘤相关性SIADH的罕见特征。在肺癌人群中，低钠血症已被确定为住院患者和晚期疾病患者的负面预后因素。在SIADH的诊断评估中，应考虑恶性肿瘤。无论演示时间如何。
