Abstract
Tumor lysis syndrome (TLS) is a life-threatening oncologic complication caused by the lysis of a vast number of malignant cells resulting in metabolic derangements and organ dysfunction. TLS can occur spontaneously before initiation of any therapies often referred to as spontaneous tumor lysis syndrome (STLS), or shortly after the induction of chemotherapy, radiotherapy, or cytolytic antibody therapy. TLS is vastly seen in patients with hematological malignancies with high rapid cell turnover rates such as Burkitt lymphoma, acute myelogenous leukemia, and acute lymphocytic leukemia, and is rarely observed in solid tumors. However, TLS can occur in solid tumors, and there are multiple reports in the literature on the occurrence of TLS in various solid tumors. In this article, we report a case of STLS in small cell lung cancer followed by a brief review of the occurrence of TLS and STLS in small cell lung cancer.
Highlights
Tumor lysis syndrome (TLS) is a life-threatening oncologic complication due to lysis of a vast number of malignant cells resulting in metabolic derangements and organ dysfunction
TLS can be of two types: laboratory TLS (LTLS), when there are no clinical symptoms associated with laboratory abnormalities, or clinical TLS (CTLS), when there are concomitant clinical symptoms related to laboratory abnormalities
CTLS denotes the presence of LTLS plus one of the following markers of organ dysfunction that is not believed to be attributable to chemotherapy agents: increased serum creatinine concentration (≥1.5 times the upper limit of normal), cardiac arrhythmia, sudden death, or seizures [1,2]
Summary
Tumor lysis syndrome (TLS) is a life-threatening oncologic complication due to lysis of a vast number of malignant cells resulting in metabolic derangements and organ dysfunction. A 53-year-old Caucasian male presented with a past medical history significant for chronic obstructive pulmonary disease (COPD), gout, hypertension, and smoking for 50 pack years. He was seen at his primary care physician’s office few weeks before admission for worsening shortness of breath, cough, and lower extremity swelling. The patient was given a prescription of oral azithromycin and furosemide Despite these medications, his breathing continued to get worse prompting him to be seen at a local emergency room. His breathing continued to get worse prompting him to be seen at a local emergency room He was found to be hypoxic on room air and in moderate to severe respiratory distress. CT scan of the chest was significant for bilateral mediastinal and hilar adenopathy (Figure 3)
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