Spontaneous acute tumor lysis syndrome with advanced gastric cancer

Abstract

Acute tumor lysis syndrome (TLS) occurs frequently in hematologic malignancies such as high-grade lymphomas and acute leukemia, which are rapidly proliferating and chemosensitive tumors. It occurs rarely in solid tumors and has never been reported in gastric adenocarcinoma. Typical biochemical findings of acute tumor lysis syndrome are hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia in patients with a malignancy. Rapid changes of these electrolytes may cause cardiac arrhythmia, seizure, acute renal failure and sudden death. Therefore, as soon as it is detected, it should be taken care of immediately. Until now almost all cases of TLS associated with solid tumor have developed after cytoreductive therapy in chemosensitive tumors. We report here a case of spontaneous acute tumor lysis in a patient of advanced gastric cancer with hepatic metastases and multiple lymphadenopathy. The biochemical finding of TLS improved with the management and tumor burden also showed slight response to the one cycled combination chemotherapy but the patient died of progressive pneumonia.

Spontaneous tumour lysis syndrome

“…[8][9][10][11] Although it occurs rarely, this syndrome can also be spontaneous in patients with solid tumours, including, but not limited to, gastric, lung and breast cancer. [12][13][14][15] There is limited information about tumour lysis syndrome and malignant involvement of the liver. Tumour lysis has been documented in patients with hepatocellular carcinoma after treatment with sorafenib 16,17 and transarterial chemoembolization.…”

An unusual case of spontaneous acute tumor lysis syndrome associated with acute lymphoblastic leukemia: A case report and review of the literature

“…However TLS is rarely observed spontaneously. Spontaneous acute TLS before treatment without any precipitating factor was reported in patients with Burkitt's leukemia/ lymphoma [11], diffuse large B cell lymphoma and Richter syndrome [10], anaplastic large T cell lymphoma [12], acute myeloid leukemia [2], metastatic germ cell tumor [3], adenocarcinoma of lung [13], breast cancer [14], gastric cancer [15] and myelofibrosis [5]. Here we present a case of spontaneous acute TLS associated with ALL.…”

Síndrome de lisis tumoral espontáneo en una paciente con linfoma no Hodgkin

“…Más recientemente, hemos encontrado 9 publicaciones que recogen un total de 13 casos de SLT. De ellos, 4 asociados a linfoma (4,6-8), uno asociado a leucemia (9), dos tumor de células germinales (10) y 6 a tumores sólidos (10)(11)(12)(13)(14).…”