Pathology · Neoplasia (Classification, Carcinogenesis, Tumor Markers, Paraneoplastic)

A 55-year-old man with small-cell lung carcinoma presents with hyponatremia and concentrated urine. The paraneoplastic syndrome responsible involves ectopic secretion of which molecule?

  • A Parathyroid hormone-related peptide (PTHrP)
  • B ACTH
  • C Antidiuretic hormone (ADH/AVP)
  • D Erythropoietin
Correct answer: C. Antidiuretic hormone (ADH/AVP)

Explanation

Small-cell lung carcinoma commonly causes SIADH via ectopic secretion of ADH/AVP, resulting in euvolemic hyponatremia with inappropriately concentrated urine. PTHrP causes hypercalcemia (typically squamous cell carcinoma), ACTH causes Cushing syndrome, and erythropoietin causes polycythemia (renal cell carcinoma).

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

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