Chemotherapy-Induced Tumour Lysis Syndrome in Gastric Adenocarcinoma with Diffuse Liver Metastases: A Case Report

Abstract

Tumour Lysis Syndrome (TLS) is an important oncological emergency case which is often found together with haematological malignities and, much less often, with solid tumours. While TLS seen in solid tumour cases usually develops following a cytotoxic chemotherapy and its prognosis is poor. We present the case of a 60-year-old man with gastric adenocarcinoma with diffuse liver metastases (image shows diffuse liver metastatic lesions) and high serum LDH levels, who developed TLS after systemic chemotherapy. With urgent and proper supportive treatment (intravenous intensive hydration, sodium bicarbonate, diuretic, calcium gluconate, allopurinol and haemodialysis), an impressive recovery from TLS was achieved in the patient with an advanced stage gastric cancer. The purpose of this report is to emphasize that although the present case was a rare, high physician attention is required because significant morbidity or mortality may occur when the syndrome is not duly considered during the pre-cytotoxic evaluation of the patient, when preventive measures are not taken, or if the appropriate treatment is not applied immediately once the syndrome appears, especially in patients who have high tumour burden solid cancer.

Tumor Lysis Syndrome in a Patient With Gastric Adenocarcinoma

“…Search results yielded 8 additional cases of TLS in gastric adenocarcinoma (Table 3). 4-11 Of these, 4 have been spontaneous TLS 4-7 and the other 4 were chemotherapy-induced. 8-11 Including our patient, the mean age at presentation was 55 years.…”

“…[4][5][6][7][8][9][10][11] Of these, 4 have been spontaneous TLS 4-7 and the other 4 were chemotherapy-induced. [8][9][10][11] Including our patient, the mean age at presentation was 55 years. All 9 patients were male.…”

Tumor Lysis Syndrome: A Rare Complication of Metastatic Gastric Cancer and a Possible Indicator of Disease Progression

“…We did a review of literature, and we summarized the 9 reported cases of TLS in gastric adenocarcinoma in Table 2. [1][2][3][4][5][6][7][8][9] Of these, 4 cases were spontaneous TLS, and the other 5 were chemotherapy-induced, with only 1 of the 5 cases being FOLFOX-induced. The mean age at presentation was 55 years and all 9 patients were males.…”