- Tumor lysis syndrome following sorafenib treatment in hepatocellular carcinoma.
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Shin Young Kim, Hee Yeon Kim, Yu Seung Kim, Sang Min Lee, Chang Wook Kim
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Yeungnam Univ J Med. 2015;32(1):47-49. Published online June 30, 2015
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DOI: https://doi.org/10.12701/yujm.2015.32.1.47
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Abstract
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- Sorafenib is indicated for the treatment of advanced hepatocellular carcinoma (HCC), but although rare, tumor lysis syndrome (TLS) can be fatal in HCC patients with a large tumor burden. The authors describe the case of a 55-year-old hepatitis B carrier who visited our clinic with progressive dyspnea for 3 weeks. Chest and abdominal computed tomography revealed a huge HCC in the left lobe of the liver with invasion of the inferior vena cava, right atrium, and pulmonary arteries. After 8 days of sorafenib administration, TLS was diagnosed based on the characteristic findings of hyperuricemia, hyperkalemia, and acute kidney injury with massive tumor necrosis by follow-up imaging. Despite discontinuation of sorafenib and supportive care, the patient's clinical course rapidly deteriorated. The authors describe a rare but fatal complication that occurred soon after sorafenib initiation for HCC. Careful follow-up is required after commencing sorafenib therapy for the early diagnosis and management of TLS.
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