Spontaneous tumor lysis syndrome in a patient with metastatic small cell carcinoma of the lung

Tumor lysis syndrome (TLS) is a life-threatening condition which could result in electrolyte imbalances, acute renal failure, seizures, arrhythmias and sudden death. It is mostly seen after the initiation of chemotherapy in hematological malignancies such as Burkitt's lymphoma and other Non-Hodgkin's Lymphoma. Solid tumors are rarely associated with Tumor Lysis Syndrome. TLS prior to the initiation of chemotherapy is known as spontaneous TLS, of which most of the literature involves hematological malignancies. There have been only a handful of case reports of spontaneous TLS occurring in solid tumors. We are presenting a patient who was newly diagnosed with metastatic small cell cancer of lung who developed spontaneous TLS. To our knowledge this is the first reported case of spontaneous TLS in small cell cancer of the lung. We will also review the literature on spontaneous TLS in solid tumors and whether as clinicians we can identify high-risk patients. Prompt diagnosis is essential in order to initiate necessary prophylactic precautions. After reviewing the few case reports it appears bulky tumors, site of metastases, prior renal functions may predict risk of suffering from TLS in solid tumors.