Tumor lysis syndrome (TLS) is an oncologic emergency that generally triggered by effective cytotoxic chemotherapy in a context of rapidly proliferating and chemo-sensitive tumor or in patients with massive tumor burden. TLS has been rarely described in patients with solid tumors, and it is even more uncommon to have spontaneous tumor lysis syndrome (STLS). To our knowledge, only three cases of STLS in metastatic breast cancer were reported in the literature. Herein, we present a new case of STLS in a 37-year-old female with giant neglected metastatic breast cancer. She subsequently developed acute oliguric renal failure and multiple electrolyte abnormalities requiring hemodialysis. Despite aggressive supportive care, the patient developed multiple organ failure and died eight days after admission. Our case highlights the importance of increased awareness of this rare but life threatening condition. TLS should be included in the differential diagnosis of patients with newly diagnosed breast cancer who present with acute kidney injury even before they receive any active cancer therapy.

Tumor Lysis Syndrome (TLS) is a well‐described metabolic oncologic emergency that can occur following the release of intracellular components either spontaneously or after the administration of active cancer therapy. Spontaneous TLS is defined as the TLS occurring in the absence of any definitive cancer treatment. TLS has been rarely described with nonhematologic solid tumors, and it is even more uncommon to have spontaneous tumor lysis syndrome (STLS) in solid tumors. To our knowledge, only three previous STLS in metastatic breast cancer were reported in the literature.

We report a case of STLS in a patient with giant neglected metastatic breast cancer together with a review of literature regarding the occurrence of STLS in patients with metastatic breast cancer and solid tumors. We also compiled clinical data on patients with solid cancers presenting with STLS to better understand risk factors, outcome and optimal management of STLS in solid tumor.

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ALPINE
Managing Editor
Journal of Molecular Oncology Research
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