School of Medicine Publications and Presentations

Document Type

Article

Publication Date

9-10-2024

Abstract

Tumor lysis syndrome (TLS) represents an oncological emergency characterized by the rapid disintegration of neoplastic cells and subsequent release of their intracellular content into the systemic circulation due to cytotoxic therapy. However, a rare variant, spontaneous TLS (STLS), can occur without an evident precipitating factor. Prompt recognition of high-risk individuals and initiation of prophylactic interventions are crucial to forestall complications of electrolyte imbalance, such as cardiac arrhythmias or sudden death. We present the case of a 74-year-old male who was referred to the hematologist/oncologist’s office after exhibiting pelvic pain, progressive weakness, fatigue, unintended weight loss over the last five months, and an imaging study revealing osteolytic lesions suggestive of a malignant condition. Initial diagnostic assessment revealed a kappa-light-restricted multiple myeloma, hypercalcemia, hyperuricemia, hyperphosphatemia, and elevated creatinine, diagnosing STLS. This case illustrates an uncommon presentation of STLS and malignant hypercalcemia in the setting of multiple myeloma. We expound upon potential tumor- and patient-specific risk factors previously documented to precipitate STLS, correlate them with our case, and provide comprehensive insights into the diagnostic, therapeutic, and noteworthy educational aspects for clinicians.

Comments

© Copyright 2024 Dorsey-Trevino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Cureus

DOI

http://doi.org/10.7759/cureus.69074

Academic Level

resident

Mentor/PI Department

Internal Medicine

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