Abstract:

Large cell neuroendocrine carcinoma (LCNEC) of cervix is a kind of cervical malignant tumor with endocrine function, which is one of the causes of syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A case of pregnancy complicated with LCNEC of cervix was reported. Mild hyponatremia was found upon hospitalization. After termination of pregnancy by cesarean section, the patient underwent neoadjuvant chemotherapy. During the chemotherapy course, the patient developed severe hyponatremia accompanied by convulsions and unconsciousness, which was diagnosed as SIADH. After implementing rescue measures such as sedation, analgesia, sodium supplementation, potassium supplementation, cranial pressure reduction, and correction of acid-base imbalance, the patient's plasma sodium concentration returned to within normal range. Subsequently, the patient underwent 3 cycles of cisplatin combined with etoposide chemotherapy and concurrent chemoradiotherapy. Eventually, the tumor recurred, and the patient unable to tolerate anti-tumor therapy due to fourth-degree bone marrow suppression and poor physical condition, which led to eventual demise. Early recognition and diagnosis of SIADH are difficult, and improper diagnosis and treatment can lead to cognitive impairment, epilepsy, coma, osmotic demyelinating syndrome, etc., affecting the prognosis of patients.

Key words: Uterine cervical neoplasms, Carcinoma, neuroendocrine, Carcinoma, large cell, Hyponatremia, Inappropriate ADH syndrome