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Tumor lysis syndrome following sorafenib treatment in hepatocellular carcinoma

  • Kim, Shin Young (Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Hee Yeon (Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Yu Seung (Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Sang Min (Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Chang Wook (Division of Hepatology, Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • Received : 2014.05.25
  • Accepted : 2014.06.26
  • Published : 2015.06.30

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.

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Cited by

  1. Sorafenib-induced tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma vol.13, pp.3, 2020, https://doi.org/10.1016/j.hemonc.2018.03.004
  2. A case of hepatocellular carcinoma caused severe tumor lysis by ramucirumab vol.62, pp.3, 2021, https://doi.org/10.2957/kanzo.62.129