Kalter Joshua A, Allen Jamie, Yang Yuchen, Willing Tyler, Evans Elizabeth
Emergency Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
Emergency Medicine, Lehigh Valley Health Network, Allentown, USA.
Cureus. 2020 Dec 19;12(12):e12169. doi: 10.7759/cureus.12169.
Spontaneous tumor lysis syndrome (STLS) is a rare oncologic emergency caused by massive cancer cell lysis or necrosis without a precipitating factor. Although tumor lysis syndrome (TLS) is most commonly associated with hematologic malignancies, a small number of cases in solid tumor malignancies have been reported. We present a case of spontaneous tumor lysis syndrome in a 77-year-old female with a widely metastatic, poorly differentiated adenocarcinoma of unknown origin. She presented in distributive shock, and laboratory testing at admission revealed acute renal failure, high anion gap metabolic acidosis, hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. Rasburicase and continuous renal replacement therapy were initiated, however, her condition deteriorated. Treatment was withdrawn and she died four days after admission.
自发性肿瘤溶解综合征（STLS）是一种罕见的肿瘤急症，由大量癌细胞溶解或坏死引起，无诱发因素。虽然肿瘤溶解综合征（TLS）最常与血液系统恶性肿瘤相关，但也有少数实体瘤恶性肿瘤病例的报道。我们报告一例77岁女性自发性肿瘤溶解综合征，该患者患有广泛转移、来源不明的低分化腺癌。她出现分布性休克，入院时实验室检查显示急性肾衰竭、高阴离子间隙代谢性酸中毒、高尿酸血症、高钾血症、高磷血症和低钙血症。开始使用重组尿酸氧化酶和持续肾脏替代治疗，然而，她的病情恶化。停止治疗，她在入院四天后死亡。
