Posters

Presenting Author

Taha Al Hassan

Presentation Type

Poster

Discipline Track

Clinical Science

Abstract Type

Case Report

Abstract

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that surfaces as a constellation of metabolic imbalances due to the rapid destruction of cancer cells and subsequent dissemination of their contents. However, a markedly rare subtype of TLS, known as spontaneous TLS (STLS), occurs without an evident trigger, such as cytotoxic therapy, and carries a similar mortality risk. It is paramount to recognize high-risk cases early and implement therapeutic measures to prevent complications of STLS.

Case Presentation: We present the case of a 74-year-old gentleman with a recent diagnosis of Kappa-restricted multiple myeloma who presented with worsening weakness, tremors, ataxia, anorexia, constipation, and unintentional weight loss over the past month. Initial workup revealed hypercalcemia, hyperuricemia, hyperphosphatemia, and new onset acute kidney injury, findings consistent with TLS based on the Cairo-Bishop Criteria; however, the patient was diagnosed with STLS as no trigger was identified. After a perusing diagnostic assessment, however, we were able to determine patient’s and tumor’s characteristics that places the patient at high risk for developing STLS.

Conclusion: Our manuscript deepens on potential causes that predisposes patients to develop STLS. Additionally, we highlight the diagnostic assessment, management, complications, and relevant learning points for clinicians.

Academic/Professional Position

Medical Student

Mentor/PI Department

Internal Medicine

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Spontaneous Tumor Lysis Syndrome in a Patient with Recent Diagnosis of Multiple Myeloma — An Unusual Presentation

Background: Tumor lysis syndrome (TLS) is an oncologic emergency that surfaces as a constellation of metabolic imbalances due to the rapid destruction of cancer cells and subsequent dissemination of their contents. However, a markedly rare subtype of TLS, known as spontaneous TLS (STLS), occurs without an evident trigger, such as cytotoxic therapy, and carries a similar mortality risk. It is paramount to recognize high-risk cases early and implement therapeutic measures to prevent complications of STLS.

Case Presentation: We present the case of a 74-year-old gentleman with a recent diagnosis of Kappa-restricted multiple myeloma who presented with worsening weakness, tremors, ataxia, anorexia, constipation, and unintentional weight loss over the past month. Initial workup revealed hypercalcemia, hyperuricemia, hyperphosphatemia, and new onset acute kidney injury, findings consistent with TLS based on the Cairo-Bishop Criteria; however, the patient was diagnosed with STLS as no trigger was identified. After a perusing diagnostic assessment, however, we were able to determine patient’s and tumor’s characteristics that places the patient at high risk for developing STLS.

Conclusion: Our manuscript deepens on potential causes that predisposes patients to develop STLS. Additionally, we highlight the diagnostic assessment, management, complications, and relevant learning points for clinicians.

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