Tumor Lysis Syndrome in a Super-responder to Chemoimmunotherapy for Nasopharyngeal Carcinoma: A Case Report

We present the case of a 54-year-old male with nasopharyngeal cancer accompanied by huge liver metastasis, an extremely high Epstein–Barr virus viral load, and B symptoms. Despite aggressive hydration and close laboratory monitoring, he developed tumor lysis syndrome (TLS) and acute kidney injury after the first cycle of chemoimmunotherapy. Although the tumor exhibited an excellent response, the patient became dialysis dependent for 8 months. This case highlights the risk of TLS in patients with nasopharyngeal carcinoma with high tumor burden, a rare but easily overlooked complication.