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Case Report
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| Tumor lysis syndrome in metastatic colon cancer after single FOLFOX cycle | ||||||
| Akanksha Agrawal1, Deepanshu Jain1, Mark Morginstin1 | ||||||
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1Department of Internal medicine, Albert Einstein Medical Center, Philadelphia, PA, USA.
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| How to cite this article |
| Agrawal A, Jain D, Morginstin M. Tumor lysis syndrome in metastatic colon cancer after single FOLFOX cycle. Int J Case Rep Images 2016;7(7):445–448. |
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Abstract
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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. | |
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Keywords:
Abdominal pain, FOLFOX, Metastatic colon cancer, Tumor lysis syndrome
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Author Contributions
Akanksha Agrawal – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, revising it critically for important intellectual content, Final approval of the version to be published Deepanshu Jain – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Mark Morginstin – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Akanksha Agrawal et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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