Pentheroudakis G, O'Neill V J, Vasey P, Kaye S B
Department of Medical Oncology, Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
Support Care Cancer. 2001 Oct;9(7):554-7. doi: 10.1007/s005200100276.
Acute tumour lysis syndrome (TLS), a condition resulting from rapid destruction of tumour cells with massive release of cellular breakdown products, has been described following the treatment of various malignancies. However, spontaneous TLS has been described only rarely. Germ cell tumours (GCT) have a rapid cell turnover and often present with bulky metastatic disease. We report two cases of patients with metastatic GCT presenting with acute renal failure attributable to spontaneous TLS. All clinical and biochemical features of the syndrome were present. Both patients were treated with haemodialysis and intravenous administration of single-agent etoposide between dialysis sessions, resulting in recovery of renal function and marked decrease in tumour bulk within the first week after presentation. These cases are the first reported instances of spontaneous TLS in poor-risk metastatic GCT. Successful treatment with dialysis and chemotherapy is possible, and prophylactic vigorous hydration and allopurinol may be warranted in this setting.
急性肿瘤溶解综合征（TLS）是一种因肿瘤细胞迅速破坏并大量释放细胞分解产物而导致的病症，在各种恶性肿瘤治疗后均有报道。然而，自发性TLS的报道却极为罕见。生殖细胞肿瘤（GCT）细胞更新迅速，常伴有巨大的转移性疾病。我们报告两例转移性GCT患者，其因自发性TLS出现急性肾衰竭。该综合征的所有临床和生化特征均存在。两名患者均接受了血液透析治疗，并在透析间隙静脉注射单药依托泊苷，结果在就诊后的第一周内肾功能恢复，肿瘤体积显著减小。这些病例是首次报道的高危转移性GCT自发性TLS病例。透析和化疗治疗可能成功，在此情况下，预防性积极补液和使用别嘌醇可能是必要的。
