前列腺癌并SIADH1例报告  

SIADH associated with prostate cancer:a case report

作　　者：许强 顿金庚 陈诚 刘理专 蒋欣杰 Xu Qiang;Dun Jingeng;Chen Cheng;Liu Lizhuan;Jiang Xinjie(Department of Urology,Xiangya Changde Hospital,Changde 415000,China)

机构地区：[1]湘雅常德医院泌尿外科,常德415000

出　　处：《中华泌尿外科杂志》2023年第9期706-707,共2页Chinese Journal of Urology

摘　　要：前列腺癌伴顽固性低钠血症临床少见,本文报道1例。患者因排尿困难人院,住院期间出现乏力、精神淡漠、神志改变,诊断为严重低钠血症。请内分泌科神经内科等多学科会诊后诊断为抗利尿激素分泌异常综合征(SIADH)。完善PSA及前列腺MRI检查,PSA升高,MRI检查考虑前列腺癌,后经前列腺穿刺确诊为前列腺癌。术前口服托伐普坦使血清钠维持正常,行腹腔镜根治性前列腺切除术。术后1个月患者乏力、纳差症状消失,停用托伐普坦并停止补钠,复查血清钠恢复正常。随访6个月,肿瘤及低钠血症未复发。Prostate cancer with refractory hyponatremia is rare.A patient was admitted with urinary retention,who developed weakness,apathy,and altered mental status during hospitalization,and was diagnosed with severe hyponatremia.After multidisciplinary consultations with departments such as endocrinology and neurology,the patient was diagnosed with syndrome of inappropriate antidiuretic hormone secretion(SIADH).The patient received serum PSA test and prostate MRI examination,and was diagnosed with prostate cancer by prostate biopsy.Laparoscopic radical prostatectomy was successfully performed.Results:The patients took tolvaptan orally before operation to maintain normal serum sodium.One month after radical prostatectomy,the symptoms of fatigue and anorexia disappeared,and serum sodium returned to normal without tolvaptan taking and sodium supplementation.No tumor recurrence or hyponatremia relapse observed during the 6-month follow-up.

关 键 词：前列腺肿瘤 癌 低钠血症 抗利尿激素分泌异常综合征 

分 类 号：R737.25[医药卫生—肿瘤] R591.1[医药卫生—临床医学]