Fatal Spontaneous Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer: A Clinical Case of Rare Oncological Emergency

Tumor lysis syndrome (TLS) is a potentially life-threatening complication of chemotherapy. It usually occurs in rapidly proliferating hematological malignancies. TLS is deemed spontaneous (STLS) when it occurs prior to any cytotoxic or definite treatment. STLS is extremely rare in solid tumors. Here, we report a rare case of fatal STLS in a 47-year-old woman diagnosed with metastatic colon cancer. The patient developed acute renal failure with anuria, electrolyte disturbances, and metabolic acidosis before initiating chemotherapy. Despite appropriate management of TLS, including renal replacement therapy, she died within a few days from multiorgan failure. Only few other case reports of STLS associated with colon cancer have been reported in the literature.

Download Full-text

Spontaneous Tumor Lysis Syndrome

Case Reports in Oncology ◽

10.1159/000509643 ◽

2020 ◽

Vol 13 (3) ◽

pp. 1116-1124

Author(s):

Wiebke Wesemüller ◽

Christian Taverna

Keyword(s):

Tumor Therapy ◽

Tumor Lysis Syndrome ◽

B Cell Lymphoma ◽

Tumor Lysis ◽

Spontaneous Tumor ◽

Oncological Emergency ◽

Life Saving ◽

Cytotoxic Treatment ◽

Tumor Load ◽

Spontaneous Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is a hemato-oncological emergency characterized by metabolic and electrolyte imbalances which are associated with disintegrating tumor cells. The syndrome is frequently observed when starting cytotoxic treatment of hematological malignancies, while the incidence of spontaneous tumor lysis prior to the start of tumor therapy is rare. Here, we present a case of spontaneous TLS in a male patient who was referred with unspecific symptoms and suspected metastatic malignancy. He developed acute renal failure before the diagnosis of a high-grade B-cell lymphoma (double hit lymphoma) and start of therapy. Although the course of TLS would have required intensive care, the patient rejected such treatment for personal reasons and died soon after the discontinuation of therapy. The case emphasizes the life-saving relevance of early detection and appropriate treatment of TLS. It also demonstrates the importance of actively screening for TLS, primarily in patients with malignant diseases and high tumor load, even if they are not receiving cytotoxic therapy.

Download Full-text

Abstract 16331: Prevalence and Outcomes of Arrhythmia in Tumor Lysis Syndrome: A National Perspective

Circulation ◽

10.1161/circ.142.suppl_3.16331 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Rupak Desai ◽

Akhil Jain ◽

Sandeep Singh ◽

Mohammed Faisaluddin ◽

Faizan Ahmad Malik ◽

...

Keyword(s):

Tumor Lysis Syndrome ◽

Population Based ◽

Hospital Charges ◽

Median Length ◽

Tumor Lysis ◽

Electrolyte Disturbances ◽

Life Threatening ◽

Multivariable Regression ◽

National Perspective ◽

Related Mortality

Introduction: Tumor lysis syndrome (TLS) is a life-threatening oncologic emergency. Epidemiology and mortality outcomes of arrhythmia in TLS are scarcely studied in the literature. Methods: We used the National Inpatient Sample (NIS) to study the prevalence and outcome of arrhythmia in patients hospitalized with TLS (ICD-9 code 277.88) from 2009-2014. Multivariable regression was performed to analyze TLS-related mortality. Results: A total of 9034 cases of arrhythmia among 37,861 TLS patients were identified. The trends in the prevalence of arrhythmia were stable with rates ranging from 19.8% to 25.8%, with the highest frequency recorded in 2014 (25.8%) (Fig. 1A). Atrial fibrillation (13.6%) was the most common arrhythmia followed by ventricular tachycardia in 2.6% of the patients (Fig. 1B). Sixty-seven percent of arrhythmias were among white old (>65) males. Arrhythmic cohort showed a higher frequency of comorbidities like fluid-electrolyte disturbances, congestive heart failure, renal failure, pulmonary circulatory disorders, deficiency anemias, etc. The most common malignancies were leukemia and lymphoma. Overall in-hospital mortality (32% vs 21.3%), the median length of stay (11 vs. 9 days) and hospital charges were higher among arrhythmic TLS patients. Conclusions: In this population-based analysis, arrhythmia in TLS was associated with higher odds of mortality and increased resource utilization. Strategies to improve the management of TLS to prevent arrhythmia is of utmost importance.

Download Full-text

Spontaneous Tumor Lysis Syndrome in a Patient with a Dedifferentiated Endometrial Adenocarcinoma

Case Reports in Oncological Medicine ◽

10.1155/2017/5103145 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Shinichi Harada ◽

Keiki Nagaharu ◽

Youichirou Baba ◽

Tetsuya Murata ◽

Toshiro Mizuno ◽

...

Keyword(s):

Endometrial Adenocarcinoma ◽

Tumor Lysis Syndrome ◽

High Sensitivity ◽

Metabolic Abnormalities ◽

Tumor Lysis ◽

Oncological Emergency ◽

Solid Malignancies ◽

Cytotoxic Treatment ◽

Spontaneous Tumor Lysis Syndrome ◽

Antineoplastic Treatment

Tumor lysis syndrome (TLS) is an oncological emergency caused by massive cytolysis of malignant cells. This syndrome eventually induces metabolic abnormalities. TLS is observed mainly among tumors with rapid cell proliferation or high sensitivity to antineoplastic treatment. In rare cases, TLS occurs without any cytotoxic treatment. Previous reports have shown that alternative stress including proceeding infection or an operation might play a role in TLS. However, exact mechanism of spontaneous TLS remains unknown. Here, we describe a case of a 59-year-old woman who presented with dedifferentiated endometrial adenocarcinoma and developed TLS without any cytotoxic chemotherapy. Although spontaneous TLS in solid malignancies are extremely rare, clinicians should consider the possibilities of TLS especially in aggressive solid tumors.

Download Full-text

Tumor Lysis Syndrome in Metastatic Colon Cancer Following Treatment with Regorafenib

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-015-9711-6 ◽

2015 ◽

Vol 46 (3) ◽

pp. 314-316 ◽

Cited By ~ 5

Author(s):

Bilal Farooqi ◽

Josh Simmons ◽

Zhonglin Hao

Keyword(s):

Colon Cancer ◽

Tumor Lysis Syndrome ◽

Metastatic Colon Cancer ◽

Tumor Lysis

Download Full-text

From skin to spontaneous lysis: A case of spontaneous tumor lysis syndrome in metastatic melanoma

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155217693425 ◽

2017 ◽

Vol 24 (3) ◽

pp. 221-225 ◽

Cited By ~ 2

Author(s):

Charis G Durham ◽

Jon Herrington ◽

Susan Seago ◽

Chelsea Williams ◽

Mark H Holguin

Keyword(s):

Metastatic Melanoma ◽

Rare Case ◽

Tumor Lysis Syndrome ◽

Cytotoxic Therapy ◽

Acute Leukemias ◽

Tumor Lysis ◽

Spontaneous Tumor ◽

Life Threatening ◽

Spontaneous Tumor Lysis Syndrome ◽

Life Threatening Complication

Tumor lysis syndrome is a life-threatening complication that often occurs after administration of cytotoxic therapy, but rarely occurs spontaneously without chemotherapy. This vignette describes a 59-year-old male with known extensive metastatic melanoma who presented to the hospital with spontaneous tumor lysis syndrome. Most spontaneous tumor lysis cases occur in patients with acute leukemias and aggressive lymphomas; however, this rare case depicts a patient with melanoma developing tumor lysis before the administration of chemotherapy.

Download Full-text

Tumor lysis syndrome in a patient with metastatic colon cancer after treatment with oxaliplatin and 5-Fu

Journal of Cancer Research and Practice ◽

10.1016/j.jcrpr.2016.03.001 ◽

2016 ◽

Vol 3 (4) ◽

pp. 124-127 ◽

Cited By ~ 2

Author(s):

Ruo-Han Tseng ◽

Ching-Hsu Wu ◽

Kuan-Lin Wu ◽

Guan-Min Lai ◽

Jen-Tsun Lin

Keyword(s):

Colon Cancer ◽

Tumor Lysis Syndrome ◽

Metastatic Colon Cancer ◽

Tumor Lysis

Download Full-text

Rapid Tumor Lysis Syndrome in a Patient with Metastatic Colon Cancer as a Complication of Treatment with 5-Fluorouracil/Leucoverin and Irinotecan

Tumori Journal ◽

10.1177/030089160409000515 ◽

2004 ◽

Vol 90 (5) ◽

pp. 514-516 ◽

Cited By ~ 25

Author(s):

Ilhan Oztop ◽

Binnaz Demirkan ◽

Arzu Yaren ◽

Oktay Tarhan ◽

Bulent Sengul ◽

...

Keyword(s):

Colon Cancer ◽

Tumor Lysis Syndrome ◽

Metastatic Colon Cancer ◽

Tumor Lysis

Download Full-text

A Case of Spontaneous Tumor Lysis Syndrome in a Patient with Ovarian Cancer

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/461870 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Kazuhiro Okamoto ◽

Toshifumi Kinoshita ◽

Miyuki Shimizu ◽

Isoji Okura ◽

Akinori Kawada ◽

...

Keyword(s):

Ovarian Tumor ◽

Tumor Recurrence ◽

Hematological Malignancies ◽

Tumor Lysis Syndrome ◽

Anticancer Therapy ◽

The Novel ◽

Chemotherapy Treatment ◽

Tumor Lysis ◽

Life Threatening ◽

Spontaneous Tumor Lysis Syndrome

Tumor lysis syndrome (TLS) is a potentially life-threating complication of tumors or chemotherapy treatment. TLS commonly occurs in hematological malignancies, but it is very rare in patients with a solid tumor. In cases of solid tumors, TLS usually occurs spontaneously and after the initiation of anticancer therapy, and it has a high mortality rate. We present the novel case of a 62-year-old woman with an ovarian tumor who spontaneously developed TLS. Surgical reduction of the tumor mass vastly improved her condition. She showed no sign of tumor recurrence 8 months after treatment. As TLS is life-threatening, successful treatments must be seriously considered.

Download Full-text