Combined small cell carcinoma of the sinonasal tract associated with syndrome of inappropriate secretion of antidiuretic hormone: A case report

Kayakabe,Mikiko; Takahashi,Katsumasa; Okamiya,Tomofumi; Segawa,Atsuki; Oyama,Tetsunari; Chikamatsu,Kazuaki

doi:10.3892/ol.2014.1882

2014-April Volume 7 Issue 4

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2014-April Volume 7 Issue 4

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Case Report

Combined small cell carcinoma of the sinonasal tract associated with syndrome of inappropriate secretion of antidiuretic hormone: A case report

Authors:
- Mikiko Kayakabe
- Katsumasa Takahashi
- Tomofumi Okamiya
- Atsuki Segawa
- Tetsunari Oyama
- Kazuaki Chikamatsu
View Affiliations / Copyright

Affiliations: Department of Otolaryngology‑Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan, Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Gunma 371‑8511, Japan
Pages: 1253-1256
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Published online on: February 13, 2014

https://doi.org/10.3892/ol.2014.1882
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Abstract

Combined small cell carcinoma (SmCC) and squamous cell carcinoma (SqCC) is a rare malignant neoplasm in the head and neck. This study presents the first reported case of combined SmCC and SqCC originating from the sinonasal tract accompanied by syndrome of inappropriate secretion of antidiuretic hormone (SIADH). An 80‑year‑old female presented with a four‑week history of right nasal discharge, nasal obstruction and left neck swelling. Imaging studies revealed a tumorous lesion in the maxillary sinus encroaching upon the right nasal cavity and left cervical lymph node (LN) swelling. An incisional biopsy carried out from the right maxillary sinus and LNs resulted in a diagnosis of combined SmCC with SqCC, staged as T4aN2cM0. Clinical examination revealed a sustained increase of antidiuretic hormone, hyponatremia with urinary sodium increase, and serum hypo‑osmosis, resulting in SIADH. Water restriction to <1,000 ml/day was effective in improving sodium and osmotic imbalance. Curative treatment for the tumor was not prescribed due to the poor condition of the patient. Palliative treatment was administered and the patient succumbed to cachexia five months after histological diagnosis. The presence of SIADH may have marked implications for the treatment and prognosis of this disease.

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