Spontaneous Tumor Lysis Syndrome: A Rare Presentation in Breast Cancer (original) (raw)

Spontaneous tumor lysis syndrome in breast cancer: a case report and discussion

journal of Cancer Therapeutics and Research, 2013

The patient was admitted to the hospital with a clinical diagnosis of: 1) stage IV Breast Cancer, 2) dehydration due to vomiting and diarrhea, 3) normocytic anemia due to acute blood loss versus anemia of chronic disease, 4) acute kidney injury possibly due to tumor lysis syndrome, 5) hyponatraemia, 6) bloody diarrhea due to infectious causes like Clostridium difficile(C Dif) colitis versus tumor. The patient was diagnosed with tumor lysis syndrome, in view of hyperkalemia (despite diarrhea), hyperphosphatemia,

Tumor Lysis Syndrome in Patients with Hematological Malignancies

Journal of Oncology

Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin’s lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk. Therefore, identifying patients at risk and prophylactic measures are important to minimize the clinical consequences of tumor lysis syndrome. Patients with low risk should receive hydration and allopurinol. On the other hand patients with high risk should receive hydration and rasburicase in an inpatient setting. It is important to start therapy immediately, to correct all parameters before cancer treatment, to assess risk level of patients...

A review of clinical and laboratory findings and treatment of tumor lysis syndrome

Clinica Chimica Acta, 2003

Acute tumor lysis syndrome (TLS) has started to be considered a separate entity or condition associated with bulk tumor treatment. TLS is described as the biochemical disturbances associated with rapid destruction of tumor cells with subsequent synchronised massive release of cellular breakdown products sufficient to overwhelm excretory mechanisms and the body's normal reutilization capacity. The cardinal signs of TLS are: hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia. This review comprehensively discusses the differential diagnosis, pathophysiology and clinical features, possible causal indications for laboratory monitoring and treatment options of TLS.

Tumor lysis syndrome in solid tumors: an up to date review of the literature

Rare Tumors, 2014

Tumor lysis syndrome (TLS) is a potentially deadly complication of tumors or their treatment. This syndrome consists of a constellation of laboratory findings such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia, known as laboratory TLS. When clinical complications such as seizures, acute renal failure, and cardiac dysrhythmias occur in patients with laboratory TLS, the syndrome is called clinical TLS. TLS is especially common in patients with hematological malignancies with rapid cellular turnover rates such as acute lymphocytic leukemia and Burkitt lymphoma, but is very rare in patients with solid tumors. Nevertheless, there are multiple reports in the literature on the occurrence of TLS in patients with solid tumors. In this review article, we summarize the current data on the occurrence of TLS in patients with solid tumors. We propose an algorithm of risk stratification and prevention of TLS in patients with solid cancers.

Rare presentation of renal failure related to tumor lysis syndrome

Caspian Journal of Pediatrics (CJP), 2018

Background: Tumor lysis syndrome (TLS) which mostly occurs in lymphoproliferative malignancies after the start of chemotherapy is an oncologic emergency. Manifestations of metabolic imbalance including increasing hyperkalemia, hyperphosphatemia, hyperuricemia and hypocalcemia are common presentation of TLS. Case report: We present two cases of spontaneous TLS; a rare presentation of TLS before cytotoxic chemotherapy. These cases were admitted with presentation of TLS without any history of chemotherapy with mediastinal mass in chest X-ray (CXR) and subsequent diagnosis of lymphoblastic lymphoma and T-cell acute lymphocytic leukemia (ALL). After several hemodialysis sessions, their conditions were improved and they underwent chemotherapy. Conclusions: It was found that the presentation of mediastinal mass in cases of lymphoma and acute leukemia might be associated with TLS before chemotherapy. In addition, it is important to pay attention to CXR, when we face to a patient with acute renal failure related to TLS.

Acute renal failure due to tumor lysis syndrome in a patient with non-Hodgkin’s lymphoma

Annals of Hematology, 2005

Tumor lysis syndrome is characterized by multiple metabolic derangements resulting from the release of intracellular components into the bloodstream due to abrupt malignant cell death, spontaneously or following antineoplastic therapy. The syndrome is characterized by hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia, while deposition of uric acid and calcium phosphate crystals may result in acute renal failure, which is often exacerbated by concomitant intravascular volume depletion. A case of tumor lysis syndrome complicated by acute renal failure in a patient with non-Hodgkin’s lymphoma is reported and the pathophysiology, the clinical features, and the treatment options are discussed.

Tumour Lysis Syndrome: Implications for Cancer Therapy

Asian Pacific Journal of Cancer Prevention, 2012

The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected release of cellular components into the circulation as a result of massive destruction of rapidly proliferating malignant cells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkin and Burkitt's lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS is seldom observed in relation to solid tumours, there have been reports of connections with examples such as lung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications such as acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Therefore early detection of TLS is of vital importance. This can be accomplished by identification of high risk patients, implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoing chemotherapy.

Assessment of tumor lysis syndrome cases

Cumhuriyet Medical Journal

Tumor lysis syndrome (TLS) is a clinical picture that occurs with the rapid destruction of tumor cells and with life-threatening metabolic disorders. The aim of our study is to evaluate the etiologic causes, diagnosis and treatment of TLS cases. Method: The study was conducted between January 2015 and December 2017 in Kahramanmaras Necip Fazıl city Hospital. A total of 32 patients diagnosed with TLS were included in the study. Laboratory values of patients were scanned (blood urea nitrogen, creatinine, potassium, phosphorus, calcium, serum uric acid, lactate dehydrogenase) and diagnoses, chemotherapy and treatments were noted. Results: Of the 32 patients who were included in the study, 17 were male and 15 were female. The average age of the patients was found as 62,06 ± 12,10 (35-86) years. Hematologic malignancy was detected in the etiology of 11 of the TLS cases and solid tumor was detected in 21 of the TLS cases. A total of 12 (37.5%) patients had spontaneous TLS (5 in haematological malignancy and 7 in solid tumor). Hyperpotassaemia 50%, hypocalcaemia 46.9%, hyperphosphatemia, hyperuricemia and acute kidney damage was present in all patients. Mortality rate was found as 40.6%. Conclusions: In our study, spontaneous TLS was detected at a high rate. In addition, the mortality rate was also high. Early diagnosis and urgent treatment should be planned to avoid mortalities.