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A case report of tumor lysis syndrome after stage-one ALPPS

RATIONALE: Tumor lysis syndrome is a potentially lethal condition caused by rapid cell death, releasing a high level of toxic cytokines. It is common in patients with hematological malignancy but rare in solid tumors. PATIENT CONCERNS: A 64-year-old patient presented to our unit with a 17.3-cm hepat...

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Autores principales: Cheung, Ho Hung, She, Wong Hoi, Yap, Desmond Y.H., Tsang, Simon H.Y., Cheung, Tan To
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913076/
https://www.ncbi.nlm.nih.gov/pubmed/35451414
http://dx.doi.org/10.1097/MD.0000000000029040
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author Cheung, Ho Hung
She, Wong Hoi
Yap, Desmond Y.H.
Tsang, Simon H.Y.
Cheung, Tan To
author_facet Cheung, Ho Hung
She, Wong Hoi
Yap, Desmond Y.H.
Tsang, Simon H.Y.
Cheung, Tan To
author_sort Cheung, Ho Hung
collection PubMed
description RATIONALE: Tumor lysis syndrome is a potentially lethal condition caused by rapid cell death, releasing a high level of toxic cytokines. It is common in patients with hematological malignancy but rare in solid tumors. PATIENT CONCERNS: A 64-year-old patient presented to our unit with a 17.3-cm hepatocellular carcinoma and marginal liver reserve. The first-stage operation of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was performed. DIAGNOSIS: The patient was found to be anuric with grossly deranged electrolytes after the first-stage operation. Tumor lysis syndrome was diagnosed. INTERVENTIONS: The patient was transferred to the intensive care unit for aggressive fluid administration and continuous venovenous hemofiltration for the management of tumor lysis syndrome. OUTCOMES: The patient recovered and then underwent the second-stage operation of ALPPS with extended right hepatectomy 8 days after the initial operation without any long-term sequelae. LESSONS: ALPPS is a relatively new technique in liver surgery, entailing an increased risk of tumor lysis syndrome due to an in situ tumor after the first-stage operation. Clinicians should have a high index of suspicion regarding this potentially lethal complication with prompt management.
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spelling pubmed-89130762022-03-15 A case report of tumor lysis syndrome after stage-one ALPPS Cheung, Ho Hung She, Wong Hoi Yap, Desmond Y.H. Tsang, Simon H.Y. Cheung, Tan To Medicine (Baltimore) 4500 RATIONALE: Tumor lysis syndrome is a potentially lethal condition caused by rapid cell death, releasing a high level of toxic cytokines. It is common in patients with hematological malignancy but rare in solid tumors. PATIENT CONCERNS: A 64-year-old patient presented to our unit with a 17.3-cm hepatocellular carcinoma and marginal liver reserve. The first-stage operation of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was performed. DIAGNOSIS: The patient was found to be anuric with grossly deranged electrolytes after the first-stage operation. Tumor lysis syndrome was diagnosed. INTERVENTIONS: The patient was transferred to the intensive care unit for aggressive fluid administration and continuous venovenous hemofiltration for the management of tumor lysis syndrome. OUTCOMES: The patient recovered and then underwent the second-stage operation of ALPPS with extended right hepatectomy 8 days after the initial operation without any long-term sequelae. LESSONS: ALPPS is a relatively new technique in liver surgery, entailing an increased risk of tumor lysis syndrome due to an in situ tumor after the first-stage operation. Clinicians should have a high index of suspicion regarding this potentially lethal complication with prompt management. Lippincott Williams & Wilkins 2022-03-11 /pmc/articles/PMC8913076/ /pubmed/35451414 http://dx.doi.org/10.1097/MD.0000000000029040 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 4500
Cheung, Ho Hung
She, Wong Hoi
Yap, Desmond Y.H.
Tsang, Simon H.Y.
Cheung, Tan To
A case report of tumor lysis syndrome after stage-one ALPPS
title A case report of tumor lysis syndrome after stage-one ALPPS
title_full A case report of tumor lysis syndrome after stage-one ALPPS
title_fullStr A case report of tumor lysis syndrome after stage-one ALPPS
title_full_unstemmed A case report of tumor lysis syndrome after stage-one ALPPS
title_short A case report of tumor lysis syndrome after stage-one ALPPS
title_sort case report of tumor lysis syndrome after stage-one alpps
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913076/
https://www.ncbi.nlm.nih.gov/pubmed/35451414
http://dx.doi.org/10.1097/MD.0000000000029040
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