Spontaneous acute tumor lysis syndrome with advanced gastric cancer

Acute tumor lysis syndrome (TLS) occurs frequently in hematologic malignanc ies such as high-grade lymphomas and acute leukemia, which are rapidly prol iferating and chemosensitive tumors. It occurs rarely in solid tumors and h as never been reported in gastric adenocarcinoma. Typical biochemical findi ngs of acute tumor lysis syndrome are hyperuricemia, hyperkalemia, hyperpho sphatemia and hypocalcemia in patients with a malignancy. Rapid changes of these electrolytes may cause cardiac arrhythmia, seizure, acute renal failu re and sudden death. Therefore, as soon as it is detected, it should be tak en care of immediately. Until now almost all cases of TLS associated with s olid tumor have developed after cytoreductive therapy in chemosensitive tum ors. We report here a case of spontaneous acute tumor lysis in a patient of advanced gastric cancer with hepatic metastases and multiple lymphadenopat hy. The biochemical finding of TLS improved with the management and tumor b urden also showed slight response to the one cycled combination chemotherap y but the patient died of progressive pneumonia.