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Vol.38 No.3 contents | Japanese/English |
- Case Report -
Diabetes Insipidus Caused by Pituitary Metastasis of Lung Cancer
Takashi Hirose, Keigo Tominaga, Kiyoshi Mori, Suguru Machida, Masaya Furuta* and Iwao Tsukiyama*Department of Thoracic Diseases, *Department of Radiation Therapy, Tochigi Cancer Center
We report a 63-year-old man with lung adenocarcinoma who presented with diabetes insipidus due to pituitary metastasis. He also had polydipsia and polyuria. His urine volume ranged from 4 to 5 liters daily with a similar volume of water intake. The specific gravity and osmotic pressure of his urine were 1.003 and 102 mOsm/kg, respectively. The serum osmotic pressure and antidiuretic hormone (ADH) were 298 mOsm/kg and 0.7 pg/ml, respectively. In a water deprivation test, despite an elevated serum osmotic pressure (313 mOsm/kg), the peak serum ADH level (0.8 pg/ml), and osmotic pressure (137 mOsm/kg) of the urine remained low. Chest X-ray revealed a mass lesion in the right upper lobe. Lung adenocarcinoma was diagnosed by fiberoptic bronchoscopy. Plain skull films showed destruction of the sellar floor and posterior clinoids. T1-weighted magnetic resonance images showed a sellar mass, bony destruction, and absence of a high signal intensity in the posterior lobe. Diabetes insipidus caused by pituitary metastasis of lung cancer was diagnosed. Although he was treated with radiation therapy to the pituitary gland and chemotherapy by cisplatin and irinotecan, the pituitary metastatic lesion did not improve.
key words: Lung cancer, Diabetes insipidus, Pituitary metastasis
Received: March 6, 1998
Accepted: April 8, 1998
JJLC 38 (3): 229-233, 1998
