Tumor lysis syndrome after transarterial chemoembolization of hepatocellular carcinoma: Case reports and literature review

Abstract

Tumor lysis syndrome (TLS) is a potentially lethal complication in cancer therapy. It may occur in highly sensitive tumors, especially in childhood cancer and leukemia, whereas, it is rare in the treatment of solid tumors in adults. TLS results from a sudden and rapid release of nuclear and cytoplasmic degradation products of malignant cells. The release of these can lead to severe alterations in the metabolic profile. Here, we present two cases of large hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE) that resulted in TLS. Although TLS rarely happens in the treatment of adult hepatic tumor, only a few cases have been reported. We should keep in mind that all patients with HCC, particularly those with large and rapidly growing tumors, must be closely watched for evidence of TLS after TACE.

Transarterial chemoembolization for huge hepatocellular carcinoma with diameter over ten centimeters: a large cohort study

“…For preventing tumor lysis syndrome, we regularly performed hydration. This type of complication was low [23]; however, when it occurred, mortality was high. Gastrointestinal bleeding always occurred in patients with PV invasion, particularly with a main PV embolus.…”

Spontaneous tumour lysis syndrome

“…Tumour lysis has been documented in patients with hepatocellular carcinoma after treatment with sorafenib 16,17 and transarterial chemoembolization. 18,19 One case report identified spontaneous tumour lysis syndrome in hepato cellular carcinoma, specifically in a patient who did not receive chemotherapy because of advanced stage of disease.…”

Serum IGFBP-3 is a more effective predictor than IGF-1 and IGF-2 for the development of hepatocellular carcinoma in patients with chronic HCV infection

“…Hepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide (1). It contributes to 14.8% of all cancer mortality in Egypt, with a higher incidence in males (17.3%) than in females (11.5%).…”