Pleural mesothelioma and the syndrome of inappropriate secretion of antidiuretic hormone

Our plain-English summary of Pleural mesothelioma and the syndrome of inappropriate secretion of antidiuretic hormone, by N.M. Siafakas, K. Tsirogiannis, B. Filaditaki, et al (Thorax, 1984).

The study

• Authors: N.M. Siafakas, K. Tsirogiannis, B. Filaditaki, F. Sotsiou, M. Vamvasakis
• Journal: Thorax
• Published: 1984;39(11):872-3
• Type of article: Case report
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

The authors, from the Departments of Thoracic Medicine and Histopathology at Evangelismos Hospital, Athens, Greece, described a case of malignant pleural mesothelioma associated with the syndrome of inappropriate secretion of antidiuretic hormone. They stated that only one such case had been reported before. The patient was a 58 year old man with a five month history of pain in the upper right chest and right shoulder, followed by low grade fever and a dry cough. He had worked as a clerk in the city and had no apparent exposure to asbestos. He was a former smoker. Chest radiographs showed lobulated peripheral shadows in the upper right chest. At thoracotomy there was extensive diffuse thickening of the parietal pleura with plaque formation. Biopsy showed a biphasic malignant mesothelioma. Electron microscopy found secretory granules of 70 to 100 nm in the tumour cells. He received no treatment. A month later he was readmitted with fever and confusion. Serum sodium was 122 to 128 mmol/l and plasma osmolality 258 mosmol/kg, against a urine osmolality of 390 mosmol/kg. Urinary sodium excretion was 196 mmol/24 h. Serum arginine vasopressin was 15 pg/ml (normal 4-8 pg/ml). Fluid restriction failed, and he died 27 days after admission. No necropsy was performed. The authors concluded that the tumour cells might produce, store and release antidiuretic hormone or a similar substance. They considered that their case supported an earlier suggestion that mesothelioma may often be accompanied by this syndrome.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short report described one patient treated at Evangelismos Hospital in Athens, Greece. He was a 58 year old man with biphasic malignant pleural mesothelioma who developed the syndrome of inappropriate secretion of antidiuretic hormone. He had worked as a clerk and had no apparent exposure to asbestos. He had smoked 20 cigarettes a day for 10 years and had stopped five years earlier. Biopsies taken during chest surgery confirmed the tumour, and electron microscopy found granules 70 to 100 nm in size inside tumour cells. He was readmitted a month later with fever and confusion. His blood sodium ranged from 122 to 128 mmol/l, and his plasma arginine vasopressin (antidiuretic hormone) was 15 pg/ml, above the stated normal range. He was treated with fluid restriction, did not respond, and died 27 days after admission. Permission for a necropsy was not obtained. The authors suggested that the tumour cells could have produced the hormone. They said their report supported an earlier suggestion that this tumour may often be accompanied by the syndrome.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 58 year old man admitted to Evangelismos Hospital, Athens, Greece, with five months of pain in the upper right chest and right shoulder; a former smoker (20 cigarettes a day for 10 years, stopped five years earlier)
• Exposure: No asbestos exposure was identified. The patient had worked as a clerk in the city and had no apparent exposure to asbestos.
• Main results:
  • Biopsies of the parietal pleura, taken at right thoracotomy, showed biphasic malignant mesothelioma with spindle cells and atypical epithelial cells.
  • Electron microscopy of tumour tissue showed cytoplasmic 'secretory' granules in atypical epithelial cells, estimated at between 70 and 100 nm in size.
  • On readmission a month later with fever and confusion, the patient's serum sodium ranged from 122 to 128 mmol/l on repeated measurement.
  • The patient's plasma arginine vasopressin was 15 pg/ml, above the normal range given in the article.
  • The patient's plasma osmolality was 258 mmol(mosmol)/kg and urine osmolality was 390 mosmol/kg.
  • The patient was treated with fluid restriction, did not respond, and died 27 days after admission. No necropsy was performed.
• The authors' conclusion: The authors concluded that the case met the criteria for inappropriate antidiuretic hormone secretion. They suggested that the hormone or a similar substance could have been produced, stored and released by the tumour cells. They said their report supported an earlier suggestion that mesothelioma may often be accompanied by this syndrome.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Histopathology, Chest X-Ray, Thoracotomy, Parietal Pleura, Biopsy, Biphasic Mesothelioma, Mesothelioma.

Related studies

• Mesothelioma associated with the syndrome of inappropriate secretion of antidiuretic hormone — W.H. Perks, J.C. Crow, et al. (1978)
• Platinum-bisphosphonate complexes have proven to be inactive chemotherapeutics targeted for malignant mesothelioma because of inappropriate hydrolysis — N. Margiotta, R. Ostuni, et al. (2011)
• Steroid hormone receptor in pleural solitary fibrous tumours and CD34+ progenitor stromal cells — M. Bongiovanni, L. Viberti, et al. (2002)
• Antagonists of growth hormone-releasing hormone (GHRH) inhibit the growth of human malignant pleural mesothelioma — T. Villanova, I. Gesmundo, et al. (2019)
• Antagonist of Growth Hormone-Releasing Hormone Potentiates the Antitumor Effect of Pemetrexed and Cisplatin in Pleural Mesothelioma — I. Gesmundo, F. Pedrolli, et al. (2022)
• The World Health Organization defines hormone replacement therapy as carcinogenic: is this plausible? — A.O. Mueck, H. Seeger (2008)

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