Paraneoplastic syndromes are a group of clinical conditions with specific signs and symptoms that are associated with underlying malignancies. The pathophysiology of paraneoplastic syndromes is caused by either the ectopic production of various hormones or the immune production of autoantibodies. Lung cancers are also notorious for being accompanied by paraneoplastic syndromes. The endocrine paraneoplastic syndromes most commonly associated with lung cancer include hypercalcemia of malignancy and syndrome of inappropriate antidiuretic hormone secretion (SIADH). Oftentimes, one of the initial findings in the early stages of lung malignancy is not symptoms of a primary lung neoplasm, but the symptoms and/or lab findings of a paraneoplastic syndrome. This article has been written to present a case of how an asymptomatic patient with a lung mass and lab values suggesting SIADH could benefit from an alteration to the current status quo in the work-up of hypo-osmolar hyponatremia. The main reason for writing the article is to suggest incorporating one of the United States Preventive Services Task Force (USPSTF) guidelines into the current work-up of hypo-osmolar hyponatremia. Currently, the workup for hypo-osmolar hyponatremia says, "consider chest imaging." However, incorporating one of the USPSTF screenings into a questionnaire for medical providers could be beneficial in identifying lung abnormalities sooner in patients with a smoking history and also be more appropriate in determining whether a patient should receive chest imaging.
Keywords: copd; hyponatremia; paraneoplastic syndrome; siadh; small cell lung cancer.
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