Systemic cancer presenting as diabetes insipidus. Clinical and radiographic features of 11 patients with a review of metastatic-induced diabetes insipidus
✍ Scribed by David W. Kimmel; Brian P. O'Neill
- Publisher
- John Wiley and Sons
- Year
- 1983
- Tongue
- English
- Weight
- 385 KB
- Volume
- 52
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Since computerized transaxial tomography (ClT) scanning at the Mayo Clinic (1974-1981), 25 cases of metastatic diabetes insipidus (DI) have been identified. Of 100 consecutive cases of DI of any cause, 14 were due to metastatic cancer. Diabetes insipidus was the initial presentation in 11 patients with systemic cancer. In the 11 patients, the most common sources metastatic to the posterior pituitaryhypothalamic region were lung (3) and the leukemia/lymphoma group (4). Although skull x-ray results were usually normal (9 of 1 I), CIT scanning results were abnormal in 5 of 11, including demonstration of pituitary stalk enlargement, suprasellar masses, or both. Metastases elsewhere in the nervous system were apparent in four patients. Anterior pituitary and visual system involvement occur in a minority group of patients. Cuncer 52:2355-2358. 1983. ETASTASIS to the hypothalamic-pituitary axis M (HPA) is a recognized event in some forms of systemic cancer, usually discovered as an incidental postmortem finding.'-' In symptomatic cases, diabetes insipidus (DI) is the usual clinical manifestation, especially seen in the terminal The presence of DI is the single most important feature in differentiating a pituitary adenoma from a meta~tasis.~ We report the clinical and radiologic features of 1 1
patients where DI was the initial manifestation of their cancer. We further review another 14 patients with DI resulting from metastasis from an already known cancer. A review of 100 consecutive cases of DI of any cause indicates that 14% are due to metastasis. Patients with DI deserve to have a careful search for malignancy performed before their cases are labeled as idiopathic DI.