A Diagnostic Paradox: Spontaneous Tumor Lysis Syndrome in a Patient with Undiagnosed Malignancy

Abstract

Tumor lysis syndrome entails a life-threatening metabolic complications that may progress swiftly if not recognized at an early stage, and in the absence of a prior cancer diagnosis or history of recent chemotherapy, a diagnostic dilemma arises. Although most cases are chemo-induced, spontaneous tumor lysis syndrome is a well-documented complication of aggressive tumors with a high turnover burden, as in the context of leukemia, for instance. This case study reports to you a previously healthy 51-year-old Saudi male who presented with laboratory abnormalities fulfilling the criteria for laboratory and clinical tumor lysis syndrome. This patient was successfully stabilized, achieving improvement in his previously deteriorating renal functions without the need to escalate to renal replacement therapy. Circulating blasts and pancytopenia emerged as significant findings raising the suspicion of leukemia, which warranted an urgent bone marrow biopsy, revealing later findings consistent with acute myeloid leukemia. After stabilization, he was transferred to a tertiary center with a haemato-oncology unit to resume his management plan.