Acute tumor lysis syndrome associated with transcatheter hepatic arterial chemoembolization therapy of hepatocellular carcinoma: a case report

Abstract

Tumor lysis syndrome (TLS) is rare in the treatment of hepatocellular carcinoma (HCC), but here we report a case of acute TLS associated with transcatheter hepatic arterial chemoembolization (TACE) for HCC, in a hepatitis C virus-infected 71-year-old woman with a serum alpha-fetoprotein level at 5,688ng/mL. She underwent TACE therapy with an emulsified mixture of Lipiodol, farmorubicin and mitomycin C, together with gelatin sponge particles for local HCC relapse. The patient developed signs of TLS, including acute renal failure, immediately after the procedure of TACE. Within the second day of TACE, laboratory examinations showed metabolic acidosis, hyperkalemia (7.4mEq/L), and increased serum levels of creatinine (3.7mg/dL) and uric acid (10.5mg/dL), leading to the diagnosis of acute renal failure associated with acute TLS. The patient was then treated with continuous venovenous hemodiafiltration (CVVHDF). The patient quickly improved with normalization of biochemical markers, and left our hospital on her feet one month later.