Progressive Tumor Necrosis and Lethal Hyperkalemia in a Neonate With Sacrococcygeal Teratoma (SCT)

Jona, Juda Z.

doi:10.1038/sj.jp.7200197

Cited by 21 publications

(16 citation statements)

References 9 publications

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“…We believe that the combination of hyperkalemia and hyperphosphatemia could be an indirect effect of tumor cell lysis similar to TLS occurring following standard cytotoxic therapy for malignant tumors [12,13]. IHs are benign proliferations of endothelial tissue, which are regarded as having a particular growth evolution.…”

Section: Discussionmentioning

confidence: 99%

Tumor Lysis Syndrome after Propranolol Therapy in Ulcerative Infantile Hemangioma: Rare Complication or Incidental Finding?

et al. 2012

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A 33-day-old female with an ulcerated infantile hemangioma (IH) undergoing oral therapy with propranolol 2 mg/kg per day developed hyperkalemia and hyperphosphatemia 24 h after starting medication. No electrocardiographic or clinical abnormalities secondary to the electrolyte changes were noticed. A laboratory tumor lysis syndrome (TLS) was diagnosed after excluding other causes of electrolyte imbalance in the diagnostic workup. No treatment was required to reverse the TLS condition, and the propranolol therapy was continued as the electrolyte alterations were only mild. One month later, the IH was remarkably reduced in size and no longer ulcerated. Maintenance of propranolol was extended for a total of 6 months. Parallel to the gradual involution of the IH, serum potassium and phosphorus levels returned within normal levels. We suggest that TLS may be a rare complication of ulcerated IH treated with propranolol. Clinicians must be aware and order appropriate screening tests for TLS in patients at risk.

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Section: Discussionmentioning

confidence: 99%

Tumor Lysis Syndrome after Propranolol Therapy in Ulcerative Infantile Hemangioma: Rare Complication or Incidental Finding?

et al. 2012

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“…Most clinical reviews of SCT have reported that the cause of death is cardiac arrest due to electrolyte imbalances, especially hyperkalemia [8]. Hyperkalemia, which may have been associated with manipulation of the tumor during resection, especially manipulating the tumor for intra-abdominal resection, and massive transfusion of pRBCs containing high levels of potassium [4].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, hyperkalemia, associated with tumor lysis syndrome and massive transfusion, can lead to cardiac arrest [8]. A surgical manipulation of very advanced solid tumors can increase the probability of tumor lysis [4].…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest during excision of a huge sacrococcygeal teratoma - A report of two cases -

Kim

Gwak

Park

et al. 2012

Korean J Anesthesiol

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Resection of large sacrococcygeal teratomas (SCTs) in premature neonates has been associated with significant perinatal mortality, making this a high risk procedure requiring careful anesthetic management. Most deaths during resection of SCTs are due to cardiac arrest caused by electrolyte imbalances, such as hyperkalemia, and massive bleeding during surgery. We describe two premature neonates who experienced cardiac arrest, one due to hyperkalemia and the other not due to hyperkalemia, during excision of large, prenatally diagnosed SCTs. We present here the considerations for anesthesia in premature neonates with huge SCTs.

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“…Acute tumor lysis associated with tumor manipulation or handling during surgery has been described in humans [6][7][8] and can lead to complications such as hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. 9 Hyperkalemia is the most immediate and most dangerous consequence of acute tumor lysis and may be exacerbated by hypocalcemia, acidosis, or renal failure.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia Case of the Month

Chohan

Greene²

2009

javma

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Progressive Tumor Necrosis and Lethal Hyperkalemia in a Neonate With Sacrococcygeal Teratoma (SCT)

Cited by 21 publications

References 9 publications

Tumor Lysis Syndrome after Propranolol Therapy in Ulcerative Infantile Hemangioma: Rare Complication or Incidental Finding?

Tumor Lysis Syndrome after Propranolol Therapy in Ulcerative Infantile Hemangioma: Rare Complication or Incidental Finding?

Cardiac arrest during excision of a huge sacrococcygeal teratoma - A report of two cases -

Anesthesia Case of the Month

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