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A 63-year-old man was evaluated for severe recurrent hyponatremia after developing weakness, poor appetite and gastrointestinal bleeding. Testing showed syndrome of inappropriate antidiuretic hormone secretion, or SIADH. Endoscopy found a 2.5-cm lesion in the upper stomach, and biopsy showed moderately differentiated adenocarcinoma.
He underwent laparoscopic total gastrectomy with Roux-en-Y reconstruction. Pathology showed tumor extension into the subserosa and one involved regional lymph node, with one involved regional lymph node. Tumor cells stained positive for antidiuretic hormone, supporting ectopic ADH production by the gastric cancer. Within 3 weeks of surgery, both his sodium and ADH levels returned to normal.
He later received chemotherapy. Despite treatment, the gastric cancer progressed, and he died 1.6 years after diagnosis.
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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