- 期刊
- OpenAccess
Tumor lysis syndrome in metastatic colon cancer after single FOLFOX cycle
並列摘要
Introduction: Tumor lysis syndrome (TLS) is a life-threatening oncological complication, often described in patients with a large tumor burden, more commonly among hematological malignancies. Case Report: We present a case report of 55-year-old male who presented to the emergency department with worsening abdominal pain, oliguria, nausea, vomiting and diarrhea of one-day duration. One-month prior, the patient was diagnosed with metastatic colon cancer. He was started on FOLFOX regimen the day prior. Patient was found to be in acute kidney injury with hyperkalemia, hyperuricemia and hyperphosphatemia. Patient was admitted with a diagnosis of TLS (Cairo-Bishop grade II) and managed with aggressive intravenous hydration, furosemide and single dose of rasburicase. In two days, symptoms resolved with improvement in laboratory parameters and patient was discharged after four days. Conclusion: There have been so far six published cases, reporting TLS in metastatic colon adenocarcinoma. Our case is the only one demonstrating that TLS can occur in metastatic colon cancer patient after a single cycle of FOLFOX therapy even in the absence of any pretreatment. Our patient had all known risk factors for developing TLS like large tumor burden, liver metastases, elevated pretreatment lactate dehydrogenase (LDH), use of combination chemotherapy drugs and dehydration. Unlike previously reported six cases where TLS resulted in death, our patient survived. Therefore, a clinician should maintain high index of suspicion for TLS among metastatic colon cancer patients and should do prompt intervention to prevent potentially life-threatening complications like cardiac arrhythmias, acute renal failure, seizures, or death.