You Can't Always Blame the Chemo: A Rare Case of Spontaneous Tumor Lysis Syndrome in a Patient with Invasive Ductal Cell Carcinoma of the Breast

Tumor lysis syndrome (TLS) is an oncologic emergency characterized by metabolic and electrolyte abnormalities, observed during the destruction of tumor cells. While it is commonly seen during cytotoxic treatment of hematologic malignancies, it is rarely seen or suspected in solid tumors. The inciden...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 11; no. 11; p. e6186
Main Authors Parsi, Meghana, Rai, Maitreyee, Clay, Christina
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 18.11.2019
Cureus
Subjects
Antigens
Blood
Breast cancer
Calcium phosphates
Cancer therapies
Case reports
Chemotherapy
Cytotoxicity
Dehydrogenases
Electrolytes
Family medical history
Hematology
Internal Medicine
Kidneys
Laboratories
Leukemia
Liver
Lymphoma
Mammography
Metabolism
Metabolites
Metastasis
Oncology
Patients
Pneumonia
Potassium
Tumors
Ultrasonic imaging
Uric acid
Cairo Egypt
Egypt
tumor lysis syndrome (tls)
oncologic emergency
spontaneous tumor lysis
spontaneous tumor lysis syndrome (stls)
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Summary:Tumor lysis syndrome (TLS) is an oncologic emergency characterized by metabolic and electrolyte abnormalities, observed during the destruction of tumor cells. While it is commonly seen during cytotoxic treatment of hematologic malignancies, it is rarely seen or suspected in solid tumors. The incidence of spontaneous tumor lysis (before cancer treatment) in solid malignancies is even rarer. Herein, we present the case of a spontaneous tumor lysis syndrome (STLS) in a woman who presented with chest pain and was found to have metastatic ductal cell carcinoma of the breast. She presented with acute renal failure and demonstrated all laboratory derangements consistent with TLS, despite not being on chemotherapy. Fortunately, her clinical status improved with prompt treatment, but the long-term effects of TLS can be fatal if not recognized and managed immediately. This case highlights that early recognition and appropriate treatment can be lifesaving. Furthermore, it demonstrates the importance of maintaining a high clinical suspicion in all patients with malignancy, whether hematologic or solid, of the possibility of TLS, even in the absence of chemotherapy.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.6186