Tumor Lysis Syndrome: A Rare Complication of Metastatic Gastric Cancer and a Possible Indicator of Disease Progression
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SAGE Publications Ltd
Abstract
Tumor lysis syndrome (TLS) is an oncologic emergency that is usually associated with hematologic malignancies either spontaneously or following early chemotherapy and is caused by massive tumor cell lysis. However, it has been rarely reported in solid tumors. We report a case of 25-year-old lady recently diagnosed with metastatic gastric adenocarcinoma who developed TLS after the fourth cycle of chemoimmunotherapy (FOLFOX plus Nivolumab). She presented with abdominal pain, decrease in oral intake and decreased urine output. Laboratory studies showed acute kidney injury with electrolyte disturbances and was diagnosed initially with autoimmune nephritis secondary to Nivolumab but was later found to have TLS and recovered after appropriate treatment. Soon after this complication, our patient was found to have disease progression on imaging which makes the incidence of TLS an indicator of disease progression. © The Author(s) 2022.
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Keywords
Cancer, Progression, Tumor lysis syndrome, Allopurinol, Bicarbonate, Creatinine, Fluorouracil, Folinic acid, Lactate dehydrogenase, Nitrogen, Nivolumab, Oxaliplatin, Phosphate, Potassium, Prednisone, Urea, Uric acid, Abdominal distension, Abdominal pain, Abdominal tenderness, Acute kidney failure, Adult, Article, Ascites, Bicarbonate blood level, Bone lesion, Cancer chemotherapy, Cancer growth, Cancer immunotherapy, Case report, Clinical article, Clinical examination, Computer assisted tomography, Creatinine blood level, Edema, Electrolyte disturbance, Female, Gastric metastasis, Human, Human cell, Laboratory test, Lactate dehydrogenase blood level, Lymph node metastasis, Multiple cycle treatment, Nephritis, Pericardial effusion, Peritoneum metastasis, Phosphate blood level, Pleura effusion, Potassium blood level, Proctitis, Stomach adenocarcinoma, Urea nitrogen blood level, Uric acid blood level, Urine volume