Acute Tumor Lysis Syndrome Caused by Transcatheter Oily Chemoembolization in a Patient with a Large Hepatocellular Carcinoma

Abstract

Acute tumor lysis syndrome results from a sudden and rapid release of products of cellular breakdown after anticancer therapy. Severe alterations of metabolic profile might occur and result in acute renal failure. We present a patient with a large hepatocellular carcinoma who received transcatheter oily chemoembolization and died subsequently of this syndrome. To our knowledge, there has been only one report of this syndrome induced by chemoembolization for hepatocellular carcinoma. This case illustrates the need to anticipate the development of acute tumor lysis syndrome when chemoembolization is planned for a large hepatocellular carcinoma.

Tumor lysis syndrome after transarterial chemoembolization of hepatocellular carcinoma: Case reports and literature review

“…The second patient's syndrome was detected early and treated appropriately. Another case report was published by Sakamoto et al [13] . This patient had a large HCC > 20 cm in size.…”

“…However, some solid malignancies in adults, such as breast cancer, small cell lung cancer, seminoma, metastatic Meckel's cell tumor, medulloblastoma, and even hepatoma have been reported to be the cause of TLS [9][10][11] . TLS may occur after various treatments of HCC, including radiofrequency ablation [14] , oral thalidomide [15] and TACE [12,13] . TLS arises from spontaneous cell death or within the first few days after cytotoxic therapy, and results from rapid tumor destruction.…”

“…Although TLS also has been reported in many different types of solid tumors, including lung and breast carcinoma [9][10][11] , it is still very rare in the treatment of HCC with transarterial chemoembolization (TACE). As far as we know, only a few cases have been reported in the English-language literature [12,13] . Here, we report two cases of acute TLS in patients with HCC following TACE, and review the literature.…”

Fatal liver abscess caused by <i>Clostridium perfringens</i> complicated with transarterial chemoembolization

“…However, TACE has been associated with several complications, including critical complications such as hepatic infarction, and liver abscess [2,3]. Herein, we present an extremingly rare but fatal complication caused by Clostridium perfringens after TACE for large HCC.…”

“…In the reviewed cases, the patient had already gone into shock or died before a diagnosis could be made, and 70% -100% patients did not survive; the median time between admission and death was only 8 hours [4]. Major complications of TACE, such as liver dysfunction, hepatic infarction, liver abscess, pulmonary oil embolism and tumor lysis syndrome have been well described [2,3]. To our knowledge, only 3 reports of liver abscess caused by Clostridium perfringens have been described to date [5][6][7].…”