Coexisting paraneoplastic SIAD and tumour-induced osteomalacia in stage IV small cell lung cancer: a diagnostic challenge.

Authors

Abdul Aziz, Nourhan Hassan, Mohammad Tahir Rafique Bhutta, Arshad Jamil, Reggie Sam John

Published in

BMJ case reports. Volume 19. Issue 8. Aug 14, 2026. Epub Aug 14, 2026.

Abstract

A 70-year-old man with stage IV (extensive-stage) small cell lung carcinoma presented with progressive respiratory symptoms, refractory hypophosphataemia and hyponatraemia. The diagnostic evaluation revealed paraneoplastic arginine vasopressin-mediated syndrome of inappropriate diuresis and fibroblast growth factor 23-mediated renal phosphate wasting, consistent with tumour-induced osteomalacia. This report highlights the diagnostic complexity and reasoning required to identify dual paraneoplastic syndromes in an advanced malignancy, with emphasis on biochemical interpretation and integration of laboratory data.

PMID:
42601076
Bibliographic data and abstract were imported from PubMed on 15 Aug 2026.

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