Spontaneous Tumor Lysis Syndrome in Undifferentiated Pelvic Solid Tumor with Associated New Onset Atrial Flutter: A Case Report

Tumor lysis syndrome (TLS) is an oncologic emergency that is caused by electrolyte derangements from the lysis of malignant tumor cells. The syndrome consists of several laboratory abnormalities including hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia1,2. When these lab findings are associated with end-organ damage such as acute renal failure, seizures, or cardiac dysrhythmias amongst others, it is known as clinical TLS3. TLS is more commonly associated with hematological malignancies given their tendency of rapid cellular turnover. The most common culprits include acute lymphocytic leukemia and Burkitt’s lymphoma. It is, however, quite rare for TLS to occur secondary to a solid malignancy4. In fact, only 74 cases of solid-tumor TLS have been reported between 1977-20115. Furthermore, in case of solid tumors, they are almost always related to administration of cytotoxic chemotherapy leading to rapid cell death. Therefore, the case described here of spontaneous TLS leading to atrial flutter in an 89-year-old female with large pelvic mass is a rare presentation