The Domino Effect-Treatment of Superior Vena Cava Obstruction Triggering Tumor Lysis Syndrome: A Case Report
Abstract
Oncological emergencies present in a multitude of manners-structural, metabolic, hematologic, etc. affecting multiple systems, often. Urgent institution of therapy is often required for a successful outcome. Occasionally, the treatment of one emergency can initiate a related or unrelated emergency, necessitating management of all the complications simultaneously. Superior vena cava obstruction (SVCO) is a medical emergency and most often manifests in patients with a malignant disease process requiring immediate diagnostic evaluation and therapy due to its’ life threatening presentation. The management of the SVCO is usually with chemotherapy, radiotherapy or intervention. In cases of large tumor burden, management of SVCO can trigger other complications. Tumor lysis syndrome is an oncologic emergency, which is characterized by a massive release of intracellular potassium, phosphate, and nucleic acid metabolites into the systemic circulation, which can be life-threatening. We present the case of a T-cell acute lymphoblastic leukemia with superior vena cava syndrome, developing tumor lysis syndrome on instituting definitive chemotherapy in a young patient.
Doi: 10.28991/SciMedJ-2021-0301-6
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Friedman, T., Quencer, K., Kishore, S., Winokur, R., & Madoff, D. (2017). Malignant Venous Obstruction: Superior Vena Cava Syndrome and Beyond. Seminars in Interventional Radiology, 34(04), 398–408. doi:10.1055/s-0037-1608863.
Tamir, S., Friehmann, T., Ratzon, R., Livneh, N., Spectre, G., Atar, E., … Leader, A. (2019). Computed Tomography Findings Associated With 30-Day Mortality in Patients With Malignant Superior Vena Cava Syndrome. Journal of Computer Assisted Tomography, 43(6), 912–918. doi:10.1097/rct.0000000000000934.
Lorigan, P. C., Woodings, P. L., Morgenstern, G. R., & Scarffe, J. H. (1996). Tumour lysis syndrome, case report and review of the literature. Annals of Oncology, 7(6), 631–636. doi:10.1093/oxfordjournals.annonc.a010682.
Mirrakhimov, A. E., Voore P, Khan M., and Ali A. M. (2015). Tumor lysis syndrome: A clinical review. World Journal of Critical Care Medicine, 4(2), 130-138. doi:10.5492/wjccm.v4.i2.130.
Kantarjian, H. M., Hoelzer, D., & Larson, R. A. (2001). Advances in the treatment of adult acute lymphocytic leukemia, Part II. Hematology/Oncology Clinics of North America, 15(1).
Reiter, A., Schrappe, M., Parwaresch, R., Henze, G., Müller-Weihrich, S., Sauter, S., ... & Riehm, H. (1995). Non-Hodgkin's lymphomas of childhood and adolescence: results of a treatment stratified for biologic subtypes and stage--a report of the Berlin-Frankfurt-Münster Group. Journal of Clinical Oncology, 13(2), 359-372. doi:10.1200/JCO.1995.13.2.359.
Gao, X. Z., Wei, J. G., Li, S. L., Han, J., Wang, G. N., & Li, W. C. (2020). Mediastinal T lymphoblastic lymphoma/leukemia: clinicopathological and prognostic analyses of 61 cases. Zhonghua Bing Li Xue Za Zhi = Chinese Journal of Pathology, 49(6), 601-606. doi:10.3760/cma.j.cn112151-20190929-00538.
Howard, S. C., Jones, D. P., & Pui, C.-H. (2011). The Tumor Lysis Syndrome. New England Journal of Medicine, 364(19), 1844–1854. doi:10.1056/nejmra0904569.
Hinton, J., Cerra-Franco, A., Shiue, K., Shea, L., Aaron, V., Billows, G., … Lautenschlaeger, T. (2018). Superior vena cava syndrome in a patient with locally advanced lung cancer with good response to definitive chemoradiation: a case report. Journal of Medical Case Reports, 12(1): 301. doi:10.1186/s13256-018-1843-4
Tilak, T. V. S. V. G. K., Raina, V., Kumar, L., Sharma, A., Sharma, M. C., Vishnubhatla, S., & Bakhshi, S. (2013). Superior vena cava syndrome and poor performance status at presentation affect survival in mediastinal T-lymphoblastic lymphoma—a single institute experience from India. Annals of Hematology, 92(7), 917–923. doi:10.1007/s00277-013-1727-z.
Cairo, M. S., Coiffier, B., Reiter, A., & Younes, A. (2010). Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. British Journal of Haematology, 149(4), 578–586. doi:10.1111/j.1365-2141.2010.08143.x.
Wilson, F. P., & Berns, J. S. (2014). Tumor Lysis Syndrome: New Challenges and Recent Advances. Advances in Chronic Kidney Disease, 21(1), 18–26. doi:10.1053/j.ackd.2013.07.001.
Cairo, M. S., & Bishop, M. (2004). Tumour lysis syndrome: new therapeutic strategies and classification. British Journal of Haematology, 127(1), 3–11. doi:10.1111/j.1365-2141.2004.05094.x.
Jeon, Y.-W., Kwak, D.-H., Park, S.-S., Yoon, J.-H., Lee, S.-E., Eom, K.-S., … Cho, S.-G. (2017). Effectiveness of Single-dose Rasburicase in Patients with Lymphoid Malignancies at a High Risk for Tumor Lysis Syndrome. Clinical Lymphoma Myeloma and Leukemia, 17(9), 595–603. doi:10.1016/j.clml.2017.06.027.
Abousaud, M. I., Rush, M. C., & Rockey, M. (2020). Assessment of rasburicase utilization for tumor lysis syndrome management in pediatric and adult patients in the inpatient and outpatient settings. Journal of Oncology Pharmacy Practice, 107815522094536. doi:10.1177/1078155220945368
Alakel, N., Middeke, J. M., Schetelig, J., & Bornhäuser, M. (2017). Prevention and treatment of tumor lysis syndrome, and the efficacy and role of rasburicase. OncoTargets and Therapy, Volume 10, 597–605. doi:10.2147/ott.s103864.
DOI: 10.28991/SciMedJ-2021-0301-6
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