Para-Endocrine Tumor Activity with Emphasis on Ectopic ADH Secretion

Abstract

Evidence has accumulated by biochemical, histologic, tissue incubation and tissue culture studies that some malignant tumors may synthesize substances which are either biologically and immunologically closely related to or identical with the respective natural hormone. Hormone measurements in blood and urine reflect the production rates in tumor tissue; ectopic hormone secretion by tumor cells is capable of raising respective plasma and urinary hormone concentrations several fold above normal. Hormone estimates (antidiuretic hormone, adrenocorticotrophic hormone, gonadotropins, etc.) in high risk subjects (heavy smokers, etc.) may contribute to early diagnosis of lung cancer and support therapeutic and prognostic evaluation of the cancer patient.

Antidiuretic Hormone in Bronchogenic Carcinoma

“…Since the original demonstration of antidiuretic activity in lung tumour tissue by Amatruda et al (1963), a number of studies (George et al, 1972;Lipscomb et al, 1968;Martin et al, 1972;Vorherr et al, 1974;Vorherr, 1974) appear t o suggest that tumour cells, especially those of the small anaplastic or oat-cell type, may have the ability to synthesize and secrete ADH or an ADH-like substance. In this investigation, all ten patients with bronchial carcinoma, hyponatraemia and elevated plasma ADH had small oat-cell tumours which contained detectable levels of ADH immunoactivity.…”

“…In this investigation, all ten patients with bronchial carcinoma, hyponatraemia and elevated plasma ADH had small oat-cell tumours which contained detectable levels of ADH immunoactivity. Whle it is mainly the small cell tumours which possess t h s property, there are reports that other histological types, including squamous cell tumours (Padfield et aE., 1976) and adenocarcinomas (Marks et al, 1968;Vorherr et al, 1974) may also have this capability. In this study the ADH activity was tumour specific, in that neither the squamous cell tumours nor the adenocarcinomas contained detectable ADH immunoactivity.…”

Syndrome of Inappropriate Secretion of Antidiuretic Hormone due to Malignant Thymoma

“…Between one half and two thirds of the patients in reported series of SIADH have an underlying malignancy as the etiology [12, 13]. The vast majority of patients with SIADH associated with cancer have a bronchogenic carcinoma, especially small cell carcinoma, which accounts for three quarters of the patients with cancer-associated SIADH [6, 12, 13, 14, 15]. Other tumors associated with SIADH are: lymphoma, pancreatic, laryngeal and duodenal, prostate, cervical, bladder, and colon carcinoma.…”

“…Other tumors associated with SIADH are: lymphoma, pancreatic, laryngeal and duodenal, prostate, cervical, bladder, and colon carcinoma. Other rare histologic types of tumor described with SIADH are: mesothelioma, neuroblastoma, sarcoma and malignant histiocytosis [6, 12, 13, 14, 15]. …”

Antidiuretic Hormone Immunoactivity in Tumour Tissue From Patients With Bronchogenic Carcinoma: With and Without Hyponatraemia

“…And i t has been suggested (Rees & Ratcliffe, 1974) that when small oat-cell tumours alone are considered the incidence rises to only 87:,. More recently, however, with the advent of immunoassay techniques for measuring plasma and tissue A D H immunoactivity, the notion has been forwarded that ectopic A D H secretion may be much more prevalent than previously thought, even in patients without overt hyponatraemia (Vorherr, 1974;Padfield et d., 1976;Morton el al., 1978).…”