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Journal of Medical Case Reports

, 4:110

First Online: 21 April 2010Received: 23 October 2009Accepted: 21 April 2010DOI: 10.1186-1752-1947-4-110

Cite this article as: Beier, F., Moleda, L., Guralnik, V. et al. J Med Case Reports 2010 4: 110. doi:10.1186-1752-1947-4-110


IntroductionThe syndrome of inappropriate antidiuresis is the most common cause of euvolemic hypo-osmolality. This syndrome is associated with a wide variety of diseases. However, its most frequent causes are related to malignancies, especially lung cancer. In this case report, we describe an unknown association of the syndrome of inappropriate antidiuresis with papillary thyroid cancer.

Case presentationWe present the case of a 71-year-old Caucasian, German woman with marked hyponatremia and neurological symptoms. After a detailed clinical investigation, the common causes of syndrome of inappropriate antidiuresis and other malignancies were ruled out. A thyroid nodule was detected by ultrasound and magnetic resonance imaging. Although fine needle aspiration cytology showed negative results, our patient underwent surgery. Papillary thyroid cancer was later diagnosed. After total thyroidectomy, a complete remission of the clinical symptoms occurred and our patient subsequently had iodine-131 radioactive therapy. Hyponatremia was no longer observed during the follow-up investigations.

ConclusionThis is the first reported case of paraneoplastic syndrome of inappropriate antidiuresis caused by papillary thyroid carcinoma. Since its symptoms occurred before the development of local symptoms, total thyroidectomy may provide a timely and efficient treatment for the underlying malignancy.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-4-110 contains supplementary material, which is available to authorized users.

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Autor: Fabian Beier - Lukas Moleda - Viktoria Guralnik - Philipp Hahn - Katharina Schardt - Reinhard Andreesen - Jürgen Schölmer


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