Tumor lysis syndrome (TLS) is a metabolic disturbance caused by the destruction of rapidly dividing cancer cells following administration of cytotoxic chemotherapy. The subsequent release of intracellular material results in hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.1 The clinical presentation of TLS, including acute kidney injury, results from these electrolyte abnormalities and can be life-threatening.2 Here we present the second reported case of TLS in a woman with endometrial cancer.
A 63 year old woman with newly-diagnosed endometrial cancer (International Federation of Gynecology and Obstetrics, FIGO, stage IVB) who received her first dose of carboplatin and paclitaxel four days earlier presented to the emergency room with shortness of breath and lower extremity swelling. Her physical examination was significant for a heart rate of 132 beats per minute and a respiratory rate of 26 breaths per minute. She was noted to have a harsh systolic murmur loudest at the right second intercostal space and a mildly distended abdomen. Chest radiography was unremarkable. A ventilation perfusion scan was negative for pulmonary embolism. Her labs at time of admission (Table 1) were consistent with tumor lysis syndrome. Based on the Cairo-Bishop criteria (described below), the diagnosis of tumor lysis syndrome was made.
Mainardi, MS4, Anne; Okamoto, MD, Daniel; and Lin, MD, Jianqing
"A Rare Case of Tumor Lysis Syndrome,"
The Medicine Forum:
Vol. 15, Article 16.
Available at: http://jdc.jefferson.edu/tmf/vol15/iss1/16