Diabetes Insipidus and Breast Cancer

Yap, H. Y.; Tashima, Charles K.; Blumenschein, George R.; Eckles, Nylene

doi:10.1001/archinte.1979.03630460043015

Cited by 45 publications

(13 citation statements)

References 11 publications

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“…The association of diabetes insipidus with orbital metastases in breast cancer as occurred in case 2 has been reported only once previously ( I ) and in that case the orbital involvement was diagnosed three months after diabetes insipidus. Treatment of diabetes insipidus due to breast cancer with chemotherapy or endocrine therapy has been successful in a small number of cases (4). Excellent symptomatic control of the thirst and polyuria was achieved in both our cases with vasopressin replacement but despite a good anti-tumour response in case 2 it was unable to be discontinued without symptoms of diabetes insipidus recurring.…”

Section: Metastatic Breast Cancer Presenting With Diabetes Insipidusmentioning

confidence: 66%

“…The dramatic increase in the incidence of lung cancer has also resulted in the recognition of rare patterns of metastases. Metastatic patterns are not random and appear to be dependent on properties unique to the tumor cell (4) and certain organs (5). Several factors of importance for the establishment of metastases have been identified (14) and include detachment of tumor cells (IS), arrest of circulating tumor cells in the vascular endothelium at specific sites (4, 5, 16-18) escape into the tissues (21); and angiogenesis to permit the growth of the metastatic implant Direct invasion of skeletal muscle in the chest wall and trunk is rather common in lung cancer and some other cancers (2,22,23).…”

Section: Metastatic Breast Cancer Presenting With Diabetes Insipidusmentioning

confidence: 99%

“…Several factors of importance for the establishment of metastases have been identified (14) and include detachment of tumor cells (IS), arrest of circulating tumor cells in the vascular endothelium at specific sites (4, 5, 16-18) escape into the tissues (21); and angiogenesis to permit the growth of the metastatic implant Direct invasion of skeletal muscle in the chest wall and trunk is rather common in lung cancer and some other cancers (2,22,23). Primary tumors in skeletal muscles are more common than secondary tumors (4,21). The reason for the rarity of metastatic tumors in skeletal muscle is unclear, but could be related to factors such as blood flow, metabolism, and high tissue pressure (2, 5, 23).…”

Section: Metastatic Breast Cancer Presenting With Diabetes Insipidusmentioning

confidence: 99%

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Metastatic Breast Cancer Presenting with Diabetes Insipidus

et al. 1992

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Section: Metastatic Breast Cancer Presenting With Diabetes Insipidusmentioning

confidence: 66%

Section: Metastatic Breast Cancer Presenting With Diabetes Insipidusmentioning

confidence: 99%

Section: Metastatic Breast Cancer Presenting With Diabetes Insipidusmentioning

confidence: 99%

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Metastatic Breast Cancer Presenting with Diabetes Insipidus

et al. 1992

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“…Treatment of diabetes insipidus due to breast cancer with chemotherapy or endocrine therapy has been successful in a small number of cases (4). Excellent symptomatic control of the thirst and polyuria was achieved in both our cases with vasopressin replacement but despite a good anti-tumour response in case 2 it was unable to be discontinued without symptoms of diabetes insipidus recurring.…”

mentioning

confidence: 66%

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confidence: 99%

Lumbar Muscle Metastasis from Lung Cancer—Report of a Case

Ferrigno¹,

Buccheri²

1992

Acta Oncologica

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CORRESPONDENCEclinically and pathological evidence of meningeal or intracerebral metastases was found in 60% of patients who underwent autopsy. One-third of their patients had bone metastases in the base of skull and choroidal metastases were found in 15% of the cases. These authors proposed that this distribution of metastases may indicate that the diabetes insipidus in such patients results from direct tumour extension from adjacent structures rather than solely from haematogenous spread. Our cases support this hypothesis and emphasise that eye symptoms may be a prominent additional manifestation of disease in this anatomical area. The association of diabetes insipidus with orbital metastases in breast cancer as occurred in case 2 has been reported only once previously ( I ) and in that case the orbital involvement was diagnosed three months after diabetes insipidus.Treatment of diabetes insipidus due to breast cancer with chemotherapy or endocrine therapy has been successful in a small number of cases (4). Excellent symptomatic control of the thirst and polyuria was achieved in both our cases with vasopressin replacement but despite a good anti-tumour response in case 2 it was unable to be discontinued without symptoms of diabetes insipidus recurring. This is somewhat unexpected as the posterior pituitary, unlike the anterior, receives its blood supply directly from the systemic circulation so systemic therapy should adequately penetrate this area. It is therefore likely that diabetes insipidus reflects actual destruction of neural tissue rather than just infiltration by tumour cells. This is consistent with the poor results of radiation therapy in palliating diabetes insipidus from malignant disease (1 of 19 patients responded) (1). roid cancer, and some other neoplasms ( 1-5). In an autopsy series of 747 cases of lung cancer, muscular metastases were observed in 8 cases only (1%); 4 of whom had squamous cell carcinoma (6). Hematogenous skeletal muscle metastasis of bronchial carcinoma are very rare at the clinical level (7-13). We now present a case of a 70-year-old man with squamous cell lung carcinoma metastatic to the left lumbar muscle. Case report. A 70-year-old man presented in April 1989 with a 8-month history of hoarseness, cough, and hemoptysis. He had been a heavy smoker since the age of 22. At physical examination a painless mass in the left lumbar muscle was found and chest x-rays demonstrated a large round mass in the left upper lobe. Bronchoscopy showed an endobronchial mass in the left upper bronchus, and biopsy yielded the histological diagnosis of squamous cell carcinoma (G2), also confirmed by a positive reaction for keratin. CT of the thorax showed a tumor in the left upper lobe with mediastinal nodal involvement, and a metastatic mass in the lingula. Abdominal CT confinned the presence of a well-encapsulated soft tissue mass in the left lumbar muscle with a maximum diameter of 5cm. (Figure). Brain CT was normal.Surgical resection of the mass was performed and histology showed squamous ce...

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Adrenal failure associated with hypothalamic and adrenal metastases: A case report and review of the literature

Modhi

Bauman

Nicolis

1981

Cancer

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A 59-year-old black man with adrenocortical failure was found at autopsy to have metastatic destruction of the pituitary infundibulum and of one adrenal gland. A review of the literature indicates that on the average 22% of patients dying with cancer have metastases to the adrenals, and 5% have metastases to the pituitary-hypothalamic region. Much higher incidences have been reported in some studies. By comparison, clinical hypopituitarism and hypoadrenalism due to such metastases have been reported very infrequently. This discrepancy may derive partly from failure to diagnose hypopituitarism and hypoadrenalism in the presence of disseminated cancer. we have found in the literature only one documented report that they h a v e caused adrenal failure.I2 We report on a patient with adrenocortical insufficiency who had total destruction of the pituitary infundibulum and of one of his a d r e n a l glands by metastases from a bronchogenic carcinoma. Case ReportA 59-year-old black man previously in good health was admitted with weakness, nausea, vomiting, and diarrhea of several weeks duration. On admission, he was hyperpigmented, obtunded, emaciated, and dehydrated. His blood pressure was 70150 mm Hg, and his liver was moderately enlarged. The remainder of the physical examination including the nervous and the reproductive systems showed no abnormality. The relevant laboratory data were: Na' 135 mEqll, KC 5.7 mEq/l, CI-102 mEq/l, C 0 2 16 mEq/l, blood urea nitrogen 46 mgidl, and creatinine 3 mg/dl. The chest x-ray showed a prominent left hilum but was considered negative. The patient was suspected to have primary adrenocortical failure and, after a rapid ACTH stimulation test (Table 1).was treated with i.v. saline and cortisol. H e soon became alert and normotensive, and his Na+, K+, BUN, and creatinine levels became normal. A prolonged ACTH stimulation test was performed ( Table 1). During the ensuing two weeks, the patient was well, but he later had a left-sided seizure. A brain scan revealed a right parietotemporal mass. Chest tomograms demonstrated a left hilar mass. Sonography of the abdomen revealed a mass in the left lobe of the liver. The patient refused further studies and was discharged on cortisone, Florinef, and Dilantin. The patient failed to take his medications, and again weakness, nausea, vomiting, and diarrhea developed. After five days, he had another seizure and was readmitted. On admission, the patient was cachectic, dehydrated, hypotensive, and aphasic. Routine biochemical studies again showed: Na+ 134 mEq/l, K + 6.1 mEq/l, C1-104 mEq/l, CO, 14 mEq/l, BUN 50 mg/dl, and creatinine level 2.5 mg/dl. There was again a prompt response to saline and cortisol. The aphasia, however, persisted. Two weeks later, the patient had another seizure, which was followed by left hemiplegia. He died with pneumonia a few days later.At autopsy, there was a squamous cell carcinoma of the left main stem bronchus. It had metastasized to the right adrenal gland, completely destroying it. Other metastases were in the liver...

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Diabetes Insipidus and Breast Cancer

Cited by 45 publications

References 11 publications

Metastatic Breast Cancer Presenting with Diabetes Insipidus

Metastatic Breast Cancer Presenting with Diabetes Insipidus

Lumbar Muscle Metastasis from Lung Cancer—Report of a Case

Adrenal failure associated with hypothalamic and adrenal metastases: A case report and review of the literature

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