Spontaneous tumor lysis syndrome occurring in untreated uterine cancer (original) (raw)

Tumor lysis syndrome in gynecologic cancers: An uncommon but important diagnosis to recognize

Gynecologic Oncology Reports, 2019

To describe the incidence, treatment and outcomes associated with tumor lysis syndrome (TLS) in women with gynecologic cancer (GOC). Methods: A retrospective multi-institutional review of TLS associated with GOC. Women presenting with an elevated serum uric acid managed with intravenous (IV) rasburicase were included. Descriptive statistics of patient demographics, clinical findings, and outcome data was completed. Results: From two large academic institutions N = 18 patients were found to meet inclusion criteria from 2008 to 2018, reflecting an approximate 5% incidence of clinically treated TLS associated with GOC in our cohort. Median age was 60 years, a majority were Caucasian (n = 11, 61.1%), median BMI was 36.2. TLS was associated with a high-grade GOC in n = 17 (94.4%) cases. TLS was commonly diagnosed with a new GOC (n = 12, 70.6%) and following receipt of chemotherapy in n = 9 (50.0%) cases. Six (66.7%) patients were treated with paclitaxel or combination, five (55.5%) with a platinum or combination, and two (22.2%) with a CD47 inhibitor. Chief complaints included electrolyte and renal abnormalities (n = 11, 73.3%). Peak serum uric acid, potassium, creatinine and phosphorus levels were 14.1 mg/dL, 5.7 mEq/L, 5.1 mg/dL, and 6.8 mg/dL, respectively. Nine patients received hospice during their admission with 3 (20%) deaths occurring as inpatients. There were 12 deaths with median OS of 16 d (range: 2-87 d). Conclusions: Though rare, TLS can be associated with GOC. Early recognition of presenting symptoms, laboratory findings and expedited treatment may help with electrolyte recovery; however, TLS associated with GOC may herald a rapidly deteriorating state with significant associated mortality.

Synchronous Primary Ovarian and Endometrial Cancers

Obstetrics & Gynecology, 2009

Synchronous primary ovarian and endometrial cancers are quite unusual based on our previous experience . Confirmative diagnosis depends on the pathologic recognition of different histologic patterns. Although some researchers have tried to determine the underlying mechanisms for the development of synchronous tumors using advanced molecular or clonal analysis, the etiologies of such tumors remain unclear . A recently proposed hypothesis suggests that the etiology of synchronous cancers is related to the embryologically similar organs that develop synchronous neoplasms when they are simultaneously subjected to carcinogens.

Case 9341 - It seemed a terrible pelvic tumor

Eurorad – European Radiology Online Database – “Certified Radiological Teaching Cases”, 2011

A 65-year-old woman, nurse, residing in Bissau, Guinea, came to the emergency department because she was having asthenia, weight loss and diffuse abdominal pain complaints for a month.

The patient with severe sideropenic anemia and giant solitary ovarian tumor

Endocrine Oncology and Metabolism, 2017

Ovarian tumors composed of granulosa cells represent 1-3% of all ovarian tumors. They are commonly estrogen secreting tumors. We present a case of a postmenopausal woman who presented with severe anemia, metrorrhagia, and a palpable tumor mass in her lower right abdomen. Subsequent diagnostic work-up confirmed a gigantic granulosa-cell tumor of the right ovary. This case highlights that the presence of metrorrhagia in a postmenopausal women with an ovarian tumor should always raise the suspicion of a granulosa-cell tumor. Gonadotropins, estradiol, and inhibin B should be measured to establish the diagnosis preoperatively. This could potentially help in treatment decision-making and long-term follow-up.

Uterine cancers

Journal of the National Comprehensive Cancer Network : JNCCN, 2006

Bilateral massive ovarian edema: A case report Khoiwal et al. Bilateral massive ovarian edema

Journal of the Turkish-German Gynecological Association, 2020

What is your diagnosis? An unmarried girl aged 17 years presented to our outpatient department with abdominal distension, dull aching abdominal pain, and amenorrhoea since 3 months. She attained menarche at 15 years of age and her previous menstrual cycles were regular with average flow. General physical examination was within normal limit. Abdominal examination revealed a firm, non-tender, mobile abdominopelvic mass corresponding to 22 weeks of uterus size. Ultrasound (USG) showed a large solid cystic right adnexal mass with internal septations. In view of suspicion of ovarian malignancy, tumor markers were ordered. The serum values of Ca-125 (28.5 U/ml), CA19.9 (24.6 U/ml), CEA (0.67 ng/ml), AFP (1.5 IU/ml), HCG (1.2 mIU/ml) were within normal limit and LDH (403 U/l) was raised. CECT abdomen & pelvis (Figure 1) suggested a well defined solid multi-cystic abdominopelvic mass lesion (20.7x14.6x14 cm) arising from right adnexa with enhancing septations and hyper dense component probably ovarian adenocarcinoma. Right ovary was not seen separately. Uterus was normal in size and left ovary was not seen properly. These findings led to a high clinical suspicion of ovarian malignancy and a plan of conservative staging laparotomy with right salpingo-ovariotomy was made in conjunction with oncology department. Answer Laparotomy was performed, intraoperative findings were suggestive of bilateral ovarian masses, an 8x6 cm solid cystic left ovarian mass and 10x8 cm multi cystic right ovarian mass (Figure 2). Left sided mass was appeared to be malignant with no salvageable ovarian tissue. Left salpingo-ovariotomy and right sided cyst drainage followed by excision of cyst wall was performed. Cut section of left ovarian mass showed both solid and cystic areas containing clear fluid, solid area appeared white (Figure 3). Right ovary had multiple clear fluid filled cystic areas. Intraoperative frozen section was suggestive of serous cystadenoma. Postoperative course was uneventful. Final histopathological (HPE) examination of left ovary and right ovarian cyst wall revealed ovarian parenchyma with markedly loose and