Georges El Hachem1* and Ziad El Ali2
1Fellow in Medical Oncology at Institut Jules Bordet, Université libre de Bruxelles, Belgium
2Medical Oncology Department, Institut Jules Bordet, Université libre de Bruxelles, Brussels, Belgium
*Corresponding Author: Georges El Hachem, Fellow in Medical Oncology at Institut Jules Bordet, Université Libre de Bruxelles, Belgium.
Received: May 30, 2017; Published: July 26, 2017
Citation: Georges El Hachem and Ziad El Ali. “Spontaneous Tumor Lysis Syndrome, an Unusual Complication of Metastatic Neuroendocrine Carcinoma of Unknown Primary”. Acta Scientific Cancer Biology 1.1 (2018).
Tumor lysis syndrome is one of the life threatening oncologic emergencies, occurring much more frequently in hematologic malignancies compared to solid tumors. It is described following administration of cytotoxic chemotherapy. It is called spontaneous if it occurs before initiating any antineoplastic treatment, and is usually seen in hematologic malignancies with high turnover rates.
Here we report the case of a 61 years old man, who was referred to our hospital for management of a hypermetabolic, retroperitoneal mass of 20 x 10 x 11 cm with retroperitoneal adenopathies. Laboratory tests showed a normal creatinine, high LDH (1056 IU/L; normal > 225 IU/L), normal electrolytes and uric acid values. Unfortunately, he developed oliguric acute kidney injury, with concomitant rising in LDH (2038 IU/L), and hyperuricemia (8.4 mg/dL); however, the phosphorus and calcium levels remained normal. The pathology came back in favour of a high grade, poorly differentiated neuroendocrine carcinoma, Ki-67 of 40%. After excluding all other causes of renal failure, our patient was diagnosed with spontaneous tumor lysis syndrome. He received an adequate supportive treatment (hydration, hypouricemic agents) and adequate cytotoxic chemotherapy. Ten days later, he was discharged with normal renal function and near normal LDH.
To date and to the best of our knowledge, this is the first case of spontaneous tumor lysis syndrome in metastatic neuroendocrine carcinoma of unknown primary. It is a rare entity that should be considered whenever we have a bulky high grade, chemo sensitive metastatic disease, with new onset of acute kidney injury and concomitant high LDH, hyperuricemia without hyperphosphatemia. Incidence of spontaneous tumor lysis syndrome is undetermined in solid tumors and its prognosis is usually poor.
Keywords: Tumor Lysis Syndrome; Metastatic Neuroendocrine Carcinoma
Copyright: © 2018 Georges El Hachem and Ziad El Ali. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.