JAMA Oncology Clinical Challenge

Hypernatremia and Polyuria in a Patient With Metastatic Breast CancerHypernatremia and Polyuria in a Patient With Metastatic Breast Cancer—CaseHypernatremia and Polyuria in a Patient With Metastatic Breast Cancer—Diagnosis

JAMA Oncology 10.1001/jamaoncol.2026.1592

June 11, 2026 at 11:00 AM EDT

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A 58-year-old woman with breast cancer with multiple prior courses of systemic treatments presented with hypotension, hypoxia, significant polyuria, and polydipsia. Mild thickening of the pituitary stalk was seen, while no discrete sellar or suprasellar masses were noted. What is your diagnosis?

Corresponding Author: Rushabh Shah, BS, Department of Internal Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226 (rshah@mcw.edu).

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