2381/45398
Gaurav Singh Gulsin
Gaurav Singh
Gulsin
Madeleine Louisa Bryson Jacobs
Madeleine Louisa Bryson
Jacobs
Shailesh Gohil
Shailesh
Gohil
Adam Thomas
Adam
Thomas
Miles Levy
Miles
Levy
Competing interests in a lung cancer with metastasis to the pituitary gland: syndrome of inappropriate ADH secretion versus diabetes insipidus.
University of Leicester
2019
neuroimaging
magnetic resonance imaging
computed tomography
vasopressins
conflict of interest
cancer
diabetes insipidus
hypopituitarism
inappropriate adh syndrome
neoplasm metastasis
breast
diagnosis
pituitary gland
sodium
lung cancer
metastasis to the lung
pituitary adenoma
water balance
secondary malignant neoplasm of pituitary gland
lung cancer stage iv
2019-08-29 14:32:41
Journal contribution
https://figshare.le.ac.uk/articles/journal_contribution/Competing_interests_in_a_lung_cancer_with_metastasis_to_the_pituitary_gland_syndrome_of_inappropriate_ADH_secretion_versus_diabetes_insipidus_/10210202
Metastases to the pituitary gland are rare; cancers that most commonly metastasize to the pituitary are breast and lung cancers. No specific computed tomography or magnetic resonance imaging features reliably distinguish primary pituitary masses from metastases. A combination of a detailed clinical assessment together with specialist endocrine and neuroradiology support is essential to make the rare diagnosis of a pituitary metastasis. We present the case of a man with metastatic lung cancer, initially presenting as hypopituitarism. Subtle features in the history, together with neuroimaging findings atypical for pituitary adenomas, provided clues that the diagnosis was one of the pituitary metastases. Treatment of diabetes insipidus (DI) with replacement antidiuretic hormone (ADH) was complicated by extreme difficulties in achieving a satisfactory sodium and water balance. This was the result of coexistent DI and syndrome of inappropriate ADH secretion perpetuated by the patient's primary lung cancer, a phenomenon not previously described in the literature.