Syndrome of inappropriate antidiuretic hormone secretion following neoadjuvant cisplatinum and 5fu administration in a patient with esophageal carcinoma

Abstract

We report a patient with squamous cell carcinoma of the esophagus who developed the syndrome of inappropriate antidiuretic hormone secretion (SIADH) after receiving cisplatinum (CDDP) and 5FU. The 58-year-old woman was admitted to hospital complaining of dysphagia and an esophageal carcinoma was diagnosed. Surgery was planned to be done after neoadjuvant chemotherapy. She was treated by CDDP and 5FU. However, five days following chemotherapy, the patient developed a neurological disorder and severe general fatigue ; her serum sodium concentration decreased from 142 mEq/l to 111 mEq/l. SIADH induced by CDDP administration was diagnosed, based on her hyponatremic state, the hypo-osmolality of her serum, the hyperasmolality of her urine, and her inappropriate level of plasma vasopressin. Four weeks following neoadjuvant chemotherapy, a radical esophagectomy was performed. After the operation, the same chemotherapeutic regimen was given, and SIADH reoccurred. Thus, this case, the SIADH was thought to be induced not by the esophageal carcinoma but by CDDP.