Cranial diabetes insipidus (CDI) is commonly idiopathic but can also be due to tumours of the pituitary & hypothalamus or surgery to remove these tumours. It can also occur due to infiltrative processes including metastatic malignancy. Pituitary metastases are not a common clinical entity although it can be a common finding in autopsy in advanced cancer when the pituitary & the sella have been evaluated. In this abstract, I will discuss two cases of CDI as a presentation of metastatic lung cancer compared to a case of known breast cancer that developed CDI. Weight loss can be a main presenting feature in DI due to malignancy. Our patients had normal or high Na, partial or Panhypopituitarism & adequate response to Vasopressin. It is important that a careful history & a thorough clinical examination are conducted in all cases of DI. The examination should not be only focused on signs of an endocrinopathy. Neuroimaging does not always differentiate vey well between different aetiologies of CDI & doubtful cases need to be discussed in an MDT. Treatment with Desmopressin can improve symptoms and quality of life but the prognosis is guarded with poor survival rates even in patients who had intervention.
16 - 18 Apr 2018
Society for Endocrinology