The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by hyponatremia and the plasma hypoosmolality induced by water retention attributable to persistent antidiuretic hormone (ADH) release. It has been reported that SIADH may occur due to various factors in patients with malignant tumor. We report a case of hypopharyngeal cancer complicated by SIADH following chemotherapy. A 72-year-old woman with hypopharyngeal cancer was treated by oral administration of S-1 and intravenous administration of low-dose cisplatin following radiation therapy. General fatigue and coma occurred during the third course of this chemotherapy, using S-1 and low-dose cisplatin. We believed that she had SIADH because of the results of examinations including hyponatremia, serum hypoosmolality and increasing serum ADH level. We treated her by fluid restriction and intravenous administration of hypertonic saline and furosemide, and she recovered. Unfortunately, her hypopharyngeal cancer gradually progressed and she died of acute pneumonia three months later.
Myxoma is a rare benign tumor, and occurs most commonly in the mandible and maxilla in the head and neck region. Myxoma of the larynx is extremely rare and is frequently misdiagnosed as a vocal polyp. We present the first female case of myxoma on a vocal cord and review the literature on this subject. The patient was 74 years old. She had undergone laryngomicrosurgery for a vocal cord polyp 20 years previously, but did not know the histological diagnosis. We performed laryngomicrosurgery for bilateral edematous vocal cords. Microscopic laryngoscopy demonstrated a mass in the submucosal space of the right vocal cord. The pathologic diagnosis of the mass was myxoma. Myxoma is a connective tissue tumor composed of multinucleate stellate cells suspended in an edematous, mucopolysaccharide-rich stroma. Since myxomas may infiltrate surrounding tissue, they have a high incidence of local recurrence. To prevent recurrence, myxoma should be surgically excised with surrounding normal tissue. Although no local recurrence has been detected, as myxoma is characterized by a slow growth rate, long-term follow-up is needed in this case.
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