Tumor Lysis Syndrome After Induction Chemotherapy of Small-Cell Bronchogenic Carcinoma

THE TUMOR lysis syndrome, consisting of severe hyperphosphatemia, hyperkalemia, hyperuricemia, and hypocalcemia, occurs after the effective induction chemotherapy of rapidly growing malignant neoplasms. This syndrome has been reported to complicate the treatment of acute leukemia, malignant lymphoma, and Burkitt's lymphoma.1-3The metabolic abnormalities are thought to be secondary to the release of intracellular products after cell lysis.1We report herein a case of tumor lysis syndrome that occurred after induction chemotherapy of small-cell bronchogenic carcinoma. Report of a Case A 57-year-old female smoker was admitted to the hospital with a recent history of cough, malaise, and weight loss. Pertinent physical findings included normal vital signs, cervical adenopathy, and massive hepatomegaly. Chest x-ray film showed a right lower lobe infiltrate. Percutaneous liver biopsy and bone marrow biopsy specimens demonstrated metastatic small-cell bronchogenic carcinoma. Complete blood cell count was normal. Chemistry screen showed the following values: sodium, 138 mEq/L; potassium,