Central Necrosis in Medicine / Internal Medicine — 22yo Woman | Nephrology | SMLE Q#18217
SMLE Question #18217
Medicine / Internal Medicine
Nephrology
Objective: OBJ-NEPH-HYPO-001
Last updated: February 2026
A 22-year-old woman is admitted for recurrent focal-to-generalized seizures and progressive cognitive decline. MRI brain shows a heterogeneously enhancing mass with central necrosis and surrounding vasogenic edema. She is clinically euvolemic on examination. Laboratory testing shows hypotonic hyponatremia with inappropriately concentrated urine and elevated urine sodium. What is the most likely cause of her hyponatremia?
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