Korean J Med.  2007 Apr;72(4):415-419.

A case of SIADH associated with carcinoma of the ampulla of Vater

• Park R
• Kim N
• Park YS
• Hwang JH
• Jeong SH
• Lee DH
• Kim SJ

Abstract

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is one of the most common causes of hyponatremia and results from inappropriate release of antidiuretic hormone (ADH). SIADH may be caused by a variety of malignant tumors, including central nervous system disorders, intrathoracic disorders and various pharmacologic agents. We experienced a case of SIADH associated with carcinoma of the ampulla of Vater. A 73-year-old man was admitted to hospital with abdominal pain and hiccup. Laboratory findings showed that the serum sodium concentration and serum osmolarity were extremely low, while the urine sodium concentration and urine osmolarity were inappropriately high, and the patient was diagnosed with SIADH. Endoscopy showed an ill-defined nodular ampulla of Vater and a biopsy revealed a carcinoma. Resection of the ampullary carcinoma corrected the abnormal sodium levels and restored the laboratory findings to normal. The normal conditions have been continuous for 6 months. To our knowledge, this is the first case of SIADH caused by an ampullary carcinoma.

Keyword

Inappropriate ADH syndrome; Carcinoma of ampulla of Vater; Hyponatremia

MeSH Terms

Abdominal Pain
Aged
Ampulla of Vater*
Biopsy
Central Nervous System Diseases
Endoscopy
Hiccup
Humans
Hyponatremia
Inappropriate ADH Syndrome*
Osmolar Concentration
Sodium
Sodium