Keywords
Hyperuricemia
Medical oncology
Seminoma
Tumor lysis syndrome
How to Cite
Abstract
The Tumor Lysis Syndrome is an oncological emergency, caused by destruction of the tumor cell, spontaneously or secondary to chemotherapy, generating release of the intracellular content into the bloodstream. Producing hyperuricemia, hyperphosphatemia, hypocalcemia and hyperkalemia. For its diagnosis, a high degree of suspicion and the Cairo-Bishop and Howard criteria must be applied. A case of a 35-year-old patient is presented with a history of stage IIC retroperitoneal non-gonadal seminoma. He was admitted from an outpatient clinic due to intolerance to the oral route, dehydration and paresthesia in the lower limbs, hyperkalemia, hypocalcemia and hyperuricemia, in addition, elevated serum creatinine. It was considered a diagnosis of tumor lysis syndrome; it was treated with aggressive fluid therapy at a dose of 2-3 L/m2/day of normal saline solution. In addition, rasburicase it was indicated and electrolyte disturbances were corrected. Once renal function was above 60 mL/min/1,73 m3, cytoreductive treatment with cisplatin, etoposide, and bleomycin it was started. The importance of having a diagnostic suspicion in cancer patients concluded, even in low-risk neoplasms, in addition, it is highlighted that, in the literature reviews, its incidence is subject to case reports.References
Lewis MA, Hendrickson AW, Moynihan TJ. Oncologic emergencies: Pathophysiology, presentation, diagnosis, and treatment. A Cancer J Clin. 2011; 61(5): 287-314. Doi: http://dx.doi.org/10.3322/caac.20124
Jafari A, Rezaei-Tavirani M, Salimi M, Tavakkol R, Jafari ZJSWiPH. Oncological emergencies from pathophysiology and diagnosis to treatment: a narrative review. Soc Work Public Health. 2020; 35(8): 689-709. Doi: https://doi.org/10.1080/19371918.2020.1824844
Halfdanarson TR, Hogan WJ, Madsen BE. Emergencies in Hematology and Oncology. Mayo Clin Proc. 2017; 92(4): 609-641. Doi: https://doi.org/10.1016/j.mayocp.2017.02.008
Greguska C. Managing tumor lysis syndrome. JAAPA 2021; 34(1): 10-3. Doi: https://doi.org/10.1097/01.JAA.0000723908.23506.85
McBride A, Trifilio S, Baxter N, Gregory TK, Howard SC. Managing Tumor Lysis Syndrome in the Era of Novel Cancer Therapies. J Adv Pract Oncol 2017; 8(7): 705. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188097/
Puri I, Sharma D, Gunturu KS, Ahmed. Diagnosis and management of tumor lysis syndrome. J Community Hosp Intern Med Perspect. 2020; 10(3): 269-72. Doi: https://doi.org/10.1080/20009666.2020.1761185
Howard SC, Jones DP, Pui CH. The tumor lysis syndrome. N Engl J Med. 2011; 364(19): 1844-54. Doi: http://dx.doi.org10.1056/NEJMra0904569
Berringer R. Spontaneous tumor lysis syndrome in a patient with newly diagnosed metastatic colonic adenocarcinoma. CJEM. 2018; 20(S2): S41-S3. Doi: https://doi.org/10.1017/cem.2017.378
Ochoa H, Espinosa A, Hurtado R. Síndrome de lisis tumoral. Acta Med. 2020; 18(2): 177-84. Doi: http://dx.doi.org10.35366/93892
Will A, Tholouli E. The clinical management of tumour lysis syndrome in haematological malignancies. Br J Haematol. 2011; 154(1): 3-13. Doi: https://doi.org/10.1111/j.1365-2141.2011.08697.x
Kennedy LD, Ajiboye VOJ. Rasburicase for the prevention and treatment of hyperuricemia in tumor lysis syndrome. J Onc Pharm Pract. 2010; 16(3): 205-13. Doi: https://doi.org/10.1177/1078155209348719
Klemencic S, Perkins J. Diagnosis and management of oncologic emergencies. West J Emerg Med. 2019; 20(2): 316. Doi: https://doi.org/10.5811/westjem.2018.12.37335
Jeha S. Tumor lysis syndrome. Semin Hematol. 2001; 38(4): 4-8. Doi: https://doi.org/10.1016/S0037-1963(01)90037-X
Cairo MS, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol. 2004; 127(1): 3-11. Doi: https://doi.org/10.1111/j.1365-2141.2004.05094.x
Oldenburg J, Fosså S, Nuver J, Heidenreich A, Schmoll H-J, Bokemeyer C, et al. Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24: vi125-vi32. Doi: https://doi.org/10.1093/annonc/mdt304
Mirrakhimov AE, Ali AM, Khan M, Barbaryan AJRT. Tumor lysis syndrome in solid tumors: an up to date review of the literature. Rare Tumors. 2014; 6(2): 68-76. Doi: https://doi.org/10.4081/rt.2014.5389
Matuszkiewicz-Rowinska J, Malyszko J. Prevention and Treatment of Tumor Lysis Syndrome in the Era of Onco-Nephrology Progress. Kidney Blood Press Res. 2020; 45(5): 645-60. Doi: https://doi.org/10.1159/000509934
Dubbs S. Rapid fire: tumor lysis syndrome. Emerg Med Clin North Am. 2018; 36(3): 517-25. Doi: https://doi.org/10.1016/j.emc.2018.04.003
Firwana BM, Hasan R, Hasan N, Alahdab F, Alnahhas I, Hasan S, et al. Tumor lysis syndrome: a systematic review of case series and case reports. Postgrad Med. 2012; 124(2): 92-101. Doi: https://doi.org/10.3810/pgm.2012.03.2540
Wesemüller W, Taverna C. Spontaneous Tumor Lysis Syndrome. Case Rep Oncol. 2020; 13(3): 1116-24. Doi: https://doi.org/10.1159/000509643
Vaisban E, Mosenzon O, Kolin M, Horn Y, Braester A. Spontaneous tumor lysis syndrome in solid tumors: really a rare condition?. Am J Med Sci. 2003; 325(1): 38-40. Doi: https://doi.org/10.1097/00000441-200301000-00008
Abu-Alfa AK, Younes A. Tumor lysis syndrome and acute kidney injury: evaluation, prevention, and management. Am J Kidney Dis. 2010; 55(5): S1-S13. Doi: https://doi.org/10.1053/j.ajkd.2009.10.056
El-Husseini A, Sabucedo A, Lamarche J, Courville C, Peguero A. Acute kidney injury associated with tumor lysis syndrome: a paradigm shift. Am J Emerg Med. 2012; 30(2): 390. e3-e6. Doi: https://doi.org/10.1016/j.ajem.2010.12.029
Wilson FP, Berns J. Tumor lysis syndrome: new challenges and recent advances. Adv Chronic Kidney Dis. 2014; 21(1): 18-26. Doi: https://doi.org/10.1053/j.ackd.2013.07.001
Gupta A, Moore J. Tumor Lysis Syndrome. JAMA Oncol. 2018; 4(6): 895. Doi: http://dx.doi.org10.1001/jamaoncol.2018.0613
Racek J, Rajdl D, Jungová A. Severe Hyperkalemia in a Hematology–Oncology Patient. Clin Chem. 2019; 65(2): 354-5. Doi: https://doi.org/10.1373/clinchem.2018.290387
Williams SM, Killeen A. Tumor lysis syndrome. Arch Pathol Lab Med. 2019; 143(3): 386-93. Doi: https://doi.org/10.5858/arpa.2017-0278-RS
Gonçalves JAF, Costa T, Rema J, Pinto C, Magalhães M, Esperança A, et al. Hypocalcemia in cancer patients: An exploratory study. Porto Biomed J. 2019; 4(4). Doi: https://doi.org/10.1097/j.pbj.0000000000000045
Howard SC, Trifilio S, Gregory TK, Baxter N, McBride AJAoh. Tumor lysis syndrome in the era of novel and targeted agents in patients with hematologic malignancies: a systematic review. Ann Hematol. 2016; 95(4): 563-73. Doi: https://doi.org/10.1007/s00277-015-2585-7
Coiffier B, Altman A, Pui C-H, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008; 26(16): 2767-78. Doi: https://doi.org/10.1200/jco.2007.15.0177
May HP, Mara KC, Barreto EF, Leung N, Habermann TM. Relationship between uric acid and kidney function in adults at risk for tumor lysis syndrome. Leukemia & Lymphoma. 2021: 1-8. https://doi.org/10.1080/10428194.2021.1941931
Jones GL, Will A, Jackson GH, Webb NJA, Rule S. Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology. Br J Haematol. 2015; 169(5): 661-71. Doi: http://dx.doi.org10.1111/bjh.13403
Khalighi PR, Martens KL, White AA, Li S, Silgard E, Frieze D, et al. Utilization patterns and clinical outcomes of rasburicase administration according to tumor risk stratification. J Oncol Pharm Pract. 2020; 26(3): 529-35. Doi: https://doi.org/10.1177/1078155219851543
Bose P, Qubaiah O. A review of tumour lysis syndrome with targeted therapies and the role of rasburicase. J Clin Pharm Ther. 2011; 36(3): 299-326. Doi: https://doi.org/10.1111/j.1365-2710.2011.01260.x
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