Case Reports
Tumor Lysis Syndrome after Hydrocortisone Treatment in Metastatic Melanoma: A Case Report and Review of the Literature

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ABSTRACT

Tumor lysis syndrome (TLS) is 1 of the complications that usually follows chemotherapy treatment of myelo-lymphoproliferative diseases. Corticosteroids (CS) could also induce TLS in this type of malignancies. On the other hand, TLS in solid tumors is less frequent, and CS treatment was never reported to be associated with TLS in solid tumor. Here we report the first case of TLS in a solid tumor (melanoma) after CS treatment.

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Case Report

A 56-year-old woman presented with right upper quadrant abdominal pain, nausea, and vomiting of 2 months’ duration. She also reported a loss of appetite and weight loss of 15 kg during those 2 months.

Her past medical history included excision of skin melanoma of the left shoulder (0.8 cm in length and 0.8 mm in depth) 2 years before presentation. Results of a metastatic work-up, including chest radiograph, ultrasound of the abdomen, and bone scan, were negative. She had also had a right ankle

Discussion

The sequence of events in our case strongly suggests that TLS was induced by CS treatment after admission. CS was given for the treatment of hypercalcemia. The cause of the hypercalcemia is most probably osteolysis induced by the widespread bone metastasis. Hypercalcemia is most probably responsible for some of the patient’s symptoms at presentation, including nausea and vomiting.

As mentioned earlier, all previously described patients of TLS induced by CS had lymphoproliferative disorders, 7

References (35)

  • J. Sparano et al.

    Increasing recognition of corticosteroid-induced tumor lysis syndrome in non-Hodgkin’s lymphoma

    Cancer

    (1990)
  • O.L. Loosveld et al.

    Acute tumor lysis syndrome in a patient with acute lymphoblastic leukemia after a single dose of prednisone

    Br J Haematol

    (1991)
  • C. Haller et al.

    The tumor lysis syndrome

    Ann Intern Med

    (1991)
  • C. Tiley et al.

    Tumor lysis following hydrocortisone prior to blood product transfusion in T-cell acute lymphoblastic leukaemia

    Leuk Lymphoma

    (1992)
  • J.P. Wester et al.

    [Acute tumor lysis syndrome due to mono-therapy with a corticosteroid in a patient with non-Hodgkin lymphoma]

    Ned Tijdschr Geneeskd

    (1997)
  • A.K. Coutinho et al.

    Tumor lysis syndrome in a case of chronic lymphocytic leukemia induced by high-dose of corticosteroids

    Am J Hematol

    (1997)
  • I.A. Malik et al.

    Dexamethasone-induced tumor lysis syndrome in high-grade non-Hodgkin’s lymphoma

    South Med J

    (1994)

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    Copyright © 2002 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.