Fatal tumor lysis syndrome in a patient with metastatic gastric adenocarcinoma

Moiseff, Robin; Felty, Cameron C; Liu, Xiaoying

doi:10.4322/acr.2020.225

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…Although in the present case treatment was also administered to manage breast cancer metastasis, the tumor pathology was unremarkable. TLS after radiation therapy for solid tumors has been reported for prostate cancer metastases, non-small lung cancer, gastric cancer metastases, and melanoma metastases [9‒13].…”

Section: Discussionmentioning

confidence: 99%

A Case of Tumor Lysis Syndrome during Palliative Radiotherapy for Breast Cancer Metastases

Furusawa,

Matsuishi,

Horino

et al. 2023

Case Rep Oncol

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Tumor lysis syndrome (TLS) is the rapid disintegration of a malignant tumor treated with anticancer drugs or radiation, causing electrolyte abnormalities such as elevated uric acid levels, elevated potassium and phosphorus levels, and decreased calcium levels. These abnormalities can lead to hypotension, renal dysfunction, consciousness disorders, and even death in some cases. The current patient was a 65-year-old woman who had breast cancer with local invasion, lung metastasis, and bone metastasis from the time of the initial disease onset. Despite the administration of various chemotherapy and hormone therapy regimens, the tumor increased gradually, and at 2 years and 5 months after the initial onset, pain and bleeding from metastatic infiltration of the cervical lymph nodes were noted. Therefore, radiotherapy was indicated for palliation of pain and bleeding caused by metastatic invasion of the cervical lymph nodes. Irradiation (30 Gy/10fr) was planned with a 3-field technique using 4MVX and 10MVX. Approximately 11 h after the initial irradiation, symptoms such as respiratory distress, tachycardia, and hypotension were observed. Blood tests revealed hyperuricemia and hyperkalemia, leading to a diagnosis of TLS. Dialysis and electrolyte correction were immediately initiated resulting in normalization of electrolytes and stabilization of the blood pressure. It is crucial to understand that TLS is relatively rare but can occur after radiation therapy or in solid tumors, and warrants a prompt response if suspected based on symptoms or blood findings.

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Section: Discussionmentioning

confidence: 99%

A Case of Tumor Lysis Syndrome during Palliative Radiotherapy for Breast Cancer Metastases

Furusawa,

Matsuishi,

Horino

et al. 2023

Case Rep Oncol

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“…Many different anticancer therapies are suspected of triggering TLS, such as targeted therapies, biological therapies [1], as well as other therapeutic regimens, namely, radiotherapy [2]. Moreover, recent advances in anticancer therapy introduced new, more efficient agents, which led to many more cases of TLS.…”

Section: Introductionmentioning

confidence: 99%

Pitfalls of Current Diagnostic Criteria of Tumor Lysis Syndrome

Alhamid,

Sabbagh,

Alsarraj

et al. 2024

Kidney Blood Press Res

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Background: Tumor Lysis syndrome (TLS) is a well-recognized medical emergency in patients with cancer diagnosis. The diagnostic criteria of TLS have been revised many times since it was recognized, but still have many drawbacks limit diagnosis accuracy. Summary: Autopsy studies in patients with perimortem diagnoses of TLS have shown that they may not have actually had TLS. Therefore, many cancer patients who are at risk for TLS, clinical and laboratory criteria may be fulfilled due to other causes of acute kidney injury. In this review, we aim to cast a spotlight on the shortcomings and pitfalls of the current diagnostic criteria for TLS, and propose a roadmap for developing a more rigorous criteria that improve on the diagnostic accuracy. Key messages: Causes of AKI in patients with cancer other than TLS should be considered. Because current diagnostic criteria may miss those differential diagnosis, specific biomarkers that can tell when TLS is the underlying process is an important need, besides appropriate criteria that can jump over the pitfalls in the current criteria and enhance the recognition of TLS among other causes.

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Fatal tumor lysis syndrome in a patient with metastatic gastric adenocarcinoma

Cited by 2 publications

References 14 publications

A Case of Tumor Lysis Syndrome during Palliative Radiotherapy for Breast Cancer Metastases

A Case of Tumor Lysis Syndrome during Palliative Radiotherapy for Breast Cancer Metastases

Pitfalls of Current Diagnostic Criteria of Tumor Lysis Syndrome

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