title: Syndrome of inappropriate antidiuretic hormone in a patient with leptomeningeal carcinomatosis.
abstract: BACKGROUND
  Leptomeningeal carcinomatosis is a condition in which metastatic cancer cells infiltrate the meninges of the brain and spinal cord, progressing to also involve the cerebrospinal fluid. Incidence of leptomeningeal carcinomatosis arising from an esophageal cancer is particularly rare.
  
  
  METHODS
  Here, we present a case report of a 76-year-old Caucasian man with a history of esophageal adenocarcinoma status-post chemoradiation followed by resection. He was admitted to our unit for intractable headache, nausea without emesis, anorexia, weakness, gait instability, delirium, syncope, and near syncope. Our diagnostic workup revealed leptomeningeal carcinomatosis and syndrome of inappropriate antidiuretic hormone. Our patient was treated with lumbar puncture for the headache, methotrexate for the leptomeningeal carcinomatosis, and table salt for the syndrome of inappropriate antidiuretic hormone. Despite our best efforts, our patient died 6 weeks posttreatment.
  
  
  CONCLUSIONS
  Understanding the molecular pathogenesis of the development of syndrome of inappropriate antidiuretic hormone associated with leptomeningeal carcinomatosis from metastatic esophageal adenocarcinoma would help us to identify patients at risk and treat them accordingly.
authors.affiliation: Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Roosevelt
authors.initials: R
authors.lastname: Boursiquot
authors.affiliation: Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Krol
authors.affiliation: Department of Pathology, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Sameul
authors.initials: S
authors.lastname: Hanif
authors.affiliation: Department of Radiology, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Javier
authors.initials: J
authors.lastname: Rojas
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, Drexel University College of Medicine, and I. Brodsky Associates, Philadelphia, PA, USA. maneesh.jain@drexelmed.edu.
authors.forename: Maneesh
authors.initials: M
authors.lastname: Jain
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D004938:Esophageal Neoplasms; D017809:Fatal Outcome; D020773:Headache Disorders / Q000628:therapy; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000209:etiology* / Q000628:therapy; D008297:Male; D055756:Meningeal Carcinomatosis / Q000178:diet therapy / Q000556:secondary*; D008727:Methotrexate / Q000627:therapeutic use; D017673:Sodium Chloride, Dietary / Q000627:therapeutic use; D013129:Spinal Puncture
chemical_list: D000964:Antimetabolites, Antineoplastic; D017673:Sodium Chloride, Dietary; D008727:Methotrexate
keywords: Esophageal adenocarcinoma; Leptomeningeal carcinomatosis; Syndrome of inappropriate antidiuretic hormone