術後経過中に抗利尿ホルモン分泌異常症候群(SIADH)を発症した非小細胞肺癌の1例

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An 80-year-old man was found to have an abnormal shadow in the right lung on follow-up chest computed tomography (CT) performed 2 years after left lung cancer resection. Wedge resection of the right lower lobe of the lung was performed. The resected specimen was diagnosed as squamous cell carcinoma; however, it was difficult to distinguish between primary and metastatic cancer. The clinical course between postoperative days 1 and 5 was good except for prolonged air leak after pulmonary resection. On postoperative day 8, the patient complained of general fatigue and subsequently developed syncope. Severe hyponatremia was observed, and he was consequently diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Serum sodium levels normalized following water restriction (1,000 ml/day) and correction of electrolyte abnormalities and the patients symptoms resolved. We speculate that the cause of SIADH in this case was postoperative intra-pleural inflammation and surgical stress after pulmonary resection.
2012-11-15