Tumor lysis syndrome in an extraskeletal osteosarcoma: a case report and review of the literature

Vito Emanuele Catania,Michele Vecchio,Giulia Malaguarnera,Saverio Latteri,Roberto Madeddu,Michele Malaguarnera

doi:10.1186/s13256-017-1241-3

Abstract

BackgroundThis case report describes a spontaneous tumor lysis syndrome due to a rare solid tumor.Case presentationA 65-year-old white woman had tumor lysis syndrome, which represent a dangerous oncological emergency. This syndrome occurs usually with a hematological tumor, but in this case our patient had a solid tumor, which was a rare extraskeletal osteosarcoma, localized in her pelvic region. She also had lung metastases and bilateral hydronephrosis.After spontaneous tumor lysis syndrome, she had acute renal insufficiency, which was treated with hemodialysis and successively with rasburicase, Kayexalate (sodium polystyrene sulfonate), and febuxostat.ConclusionTumor lysis syndrome represents an oncological emergency, which must be suspected and treated as soon as possible.

Highlights

This case report describes a spontaneous tumor lysis syndrome due to a rare solid tumor
Tumor lysis syndrome (TLS) is one of the major oncological emergencies; disruption is caused by massive tumor cell lysis in which the contents of the lysed tumor cells are released into the bloodstream [1]
Hematologic malignancies comprise the vast majority of TLS, which is believed to be secondary to treatment sensitivity and rapid proliferative rates [2, 3]

Summary

Background

Tumor lysis syndrome (TLS) is one of the major oncological emergencies; disruption is caused by massive tumor cell lysis in which the contents of the lysed tumor cells are released into the bloodstream [1]. In the case of abdominal or pelvic lesions the diagnosis can be very difficult, it requires confirmation after exploratory laparotomy and histopathology Such tumors may reach an enormous size before detection, because the enlarging mass may not be associated with pain. An exploration of her abdominal cavity detected a retroperitoneal mass in her right iliac region which involved the last ileal loop besides compressing the iliac vessels and infiltrating her ureter. The tumor massively invaded our patient’s abdominal cavity and metastasized in both lung fields According to these parameters, she was in a very poor prognostic subgroup, due to a very bulky and high growth rate tumor. The presence of metastatic lesions, the patient’s age, and the size were the major prognostic factors; in addition, patients with very large lesions have a worse clinical outcome

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