Tumor lysis syndrome following sorafenib treatment in hepatocellular carcinoma.
10.12701/yujm.2015.32.1.47
- Author:
Shin Young KIM
1
;
Hee Yeon KIM
;
Yu Seung KIM
;
Sang Min LEE
;
Chang Wook KIM
Author Information
1. Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. cwkim@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Hepatocellular carcinoma;
Sorafenib;
Tumor lysis syndrome
- MeSH:
Acute Kidney Injury;
Carcinoma, Hepatocellular*;
Dyspnea;
Early Diagnosis;
Follow-Up Studies;
Heart Atria;
Hepatitis B;
Humans;
Hyperkalemia;
Hyperuricemia;
Liver;
Middle Aged;
Necrosis;
Pulmonary Artery;
Thorax;
Tumor Burden;
Tumor Lysis Syndrome*;
Vena Cava, Inferior
- From:Yeungnam University Journal of Medicine
2015;32(1):47-49
- CountryRepublic of Korea
- Language:English
-
Abstract:
Sorafenib is indicated for the treatment of advanced hepatocellular carcinoma (HCC), but although rare, tumor lysis syndrome (TLS) can be fatal in HCC patients with a large tumor burden. The authors describe the case of a 55-year-old hepatitis B carrier who visited our clinic with progressive dyspnea for 3 weeks. Chest and abdominal computed tomography revealed a huge HCC in the left lobe of the liver with invasion of the inferior vena cava, right atrium, and pulmonary arteries. After 8 days of sorafenib administration, TLS was diagnosed based on the characteristic findings of hyperuricemia, hyperkalemia, and acute kidney injury with massive tumor necrosis by follow-up imaging. Despite discontinuation of sorafenib and supportive care, the patient's clinical course rapidly deteriorated. The authors describe a rare but fatal complication that occurred soon after sorafenib initiation for HCC. Careful follow-up is required after commencing sorafenib therapy for the early diagnosis and management of TLS.
