Plasma cell leukemia presenting as spontaneous tumor lysis syndrome with hypercalcemia

Abstract

Tumor lysis syndrome (TLS) is an oncologic emergency in which tumor cells undergo lysis either spontaneously or due to the initiation of cancer therapy typically presenting with hypocalcemia. We described a 62-year-old male patient with spontaneous TLS and hypercalcemia without a known malignancy, who is later discovered to have plasma cell leukemia.

Burkitt lymphoma presenting as cecum mass and spontaneous tumor lysis syndrome with hypercalcemia

“…Our patient presented with hyperkalemia, hyperphosphatemia, hyperuricemia, increased serum creatinine, and sudden death, which met the criteria for laboratory and clinical TLS, but contrary to typical TLS cases, hypercalcemia was detected in initial laboratory findings. Based on the literature, the development of TLS with hypercalcemia is a rare phenomenon reported in a few cases, mainly corresponding to hematological malignancies 12–14 . There are various ways in malignancies including ectopic production of PTH, PTHrP production, production of cytokines, tumor production of vitamin D, and bone metastasis to increase the level of calcium despite the occurrence of TLS 12 .…”

“…Based on the literature, the development of TLS with hypercalcemia is a rare phenomenon reported in a few cases, mainly corresponding to hematological malignancies. [12][13][14] There are various ways in malignancies including ectopic production of PTH, PTHrP production, production of cytokines, tumor production of vitamin D, and bone metastasis to increase the level of calcium despite the occurrence of TLS. 12 Of note, hypercalcemia should not delay the diagnosis of TLS since hypercalcemia may occur in patients with malignancy.…”

Biochemical and Hematologic Profiles in B-Cell Acute Lymphoblastic Leukemia Children

“…Kidneys are also responsible to maintain a balance of electrolytes but due to kidney infiltration by leukemic cells electrolytes imbalance may also be observed in acute leukemia patients 8,9 . Of the 4 main serum electrolytes Sodium, potassium, chloride, and calcium the excess of potassium is considered the most dangerous 10 …”

“…8,9 Of the 4 main serum electrolytes Sodium, potassium, chloride, and calcium the excess of potassium is considered the most dangerous. 10 Abnormal liver biochemistries are regularly observed in ALL patients, most often in their treatment course and usually reflect hepatic injury secondary to therapeutic interventions related to drugs. 11,12 LFT can be done to evaluate the normal function of liver by measuring the level of bilirubin, alkaline phosphate (ALP) and alanine transaminase (ALT), high level of these enzymes indicate liver disease.…”

Erratum

“…In the article entitled “Plasma Cell Leukemia Presenting as Spontaneous Tumor Lysis Syndrome with Hypercalcemia” 1 that was previously published in Volume 10 Issue 7 of Clinical Case Reports , another author's name ‘Narjes Zarei Jalalabadi’ has to be included.…”