Spontaneous non-treatment related tumuor lysis syndrome in metastatic testicular tumour

Abstract

Background: Tumour lysis syndrome (TLS) is a clinical condition characterized by hyperuricaemia, hyperkalaemia and hyperphosphataemia due to rapid release of intracellular contents into blood. The condition is usually seen during chemotherapy for rapidly dividing haemopoietic malignancies such as lymphomas and leukaemia. It is rarely seen in solid tumours, and very seldom occurs spontaneously.
Aim: To present a case of spontaneous non- treatment related tumour lysis syndrome (STLS) developing in a patient with advanced testicular tumour.
Case report: A 43-year-old patient presented with advanced testicular tumuor. There was delay in giving consent for orchidectomy. He suddenly deteriorated post-operatively while awaiting histology report and was simultaneously being worked up for chemotherapy. Serum analysis was initially normal post-operatively. It became deranged a few days later and  showed hyperuricaemia, hyperkalaemia, acidosis with elevated urea and creatinine. He died before he could get dialysis.
Conclusion: TLS may occur spontaneously in rapidly dividing tumour such as testicular tumours. It is important to be wary of this fatal complication when managing patients with tumours that have a short doubling time.

Keywords: Yolk sac testicular tumour, Tumour lysis syndrome,  Spontaneous tumour lysis syndrome, Hyperuricaemia, Hyperkalaemia, Hyperphosphataemia