Immature ovarian teratoma with hyponatremia and low serum vasopressin level

Abstract

Hyponatremia is often caused by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Hypersecretion of vasopressin from malignant tumors can be considered a cause of SIADH. Most of these ectopic productions of vasopressin are complications of small cell lung cancer. Cases concomitant with ovarian tumors are very rare, and a specific causative substance from the ovary is often unknown. A 16-year-old woman was diagnosed with an ovarian tumor. She developed hyponatremia that was resistant to medical treatment, but immediately improved after surgical resection of the tumor. Her diagnosis was SIADH caused by an ovarian tumor; however, her serum vasopressin level was normal. It is possible that a vasopressin-like substance causing SIADH was secreted by either nervous system tissue within an immature teratoma or small cell lung cancer. We should be cautious when SIADH is a complication of an ovarian tumor.

Syndrome of inappropriate antidiuretic hormone secretion associated with an ovarian immature teratoma: A case report and review of the literature

“…One of the initial cases of refractory hyponatremia was associated with a serous ovarian carcinoma with neuroendocrine differentiation ( Taskin et al, 1996 ). There have since been six published cases of immature teratoma related hyponatremia ( Lam and Cheung, 1996 , Lam and Yu, 2004 , Roman et al, 2004 , Sakamoto et al, 2016 , Iqbal and Schwenk, 2018 , Tejani et al, 2020 ). Similar to the case described, although the hyponatremia improved with medical management, it did not resolve until surgical debulking in 66% of the cases ( Lam and Cheung, 1996 , Lam and Yu, 2004 , Sakamoto et al, 2016 , Iqbal and Schwenk, 2018 , Tejani et al, 2020 ).…”

“…There have since been six published cases of immature teratoma related hyponatremia ( Lam and Cheung, 1996 , Lam and Yu, 2004 , Roman et al, 2004 , Sakamoto et al, 2016 , Iqbal and Schwenk, 2018 , Tejani et al, 2020 ). Similar to the case described, although the hyponatremia improved with medical management, it did not resolve until surgical debulking in 66% of the cases ( Lam and Cheung, 1996 , Lam and Yu, 2004 , Sakamoto et al, 2016 , Iqbal and Schwenk, 2018 , Tejani et al, 2020 ). Roman demonstrated serologically in their case that endogenous serum vasopressin levels were low, supporting evidence of tumor secreting vasopressin ( Roman et al, 2004 ).…”

Giant congenital right atrial epithelioid‐capillary hemangioma with prolonged QT interval: Case report and practical surgical treatment strategy for primary cardiac tumors in children based on 25‐year review of 299 cases

“…Hemangiomas have been reported in all age groups from 20 weeks of gestation to 86 years of age, with controversial sex predilection and controversial frequency in all four chambers of the heart . Both homogeneous and heterogeneous textures on imaging have been reported for CH …”