Lactic Acidosis: A Rare Oncological Emergency in Solid Tumors at Presentation

Area of Science:

• Oncology
• Critical Care Medicine
• Biochemistry

Background:

• Lactic acidosis is a critical condition marked by elevated blood lactate and low pH.
• It is predominantly observed in hematologic malignancies.
• The pathophysiology involves complex interactions between lactate production and utilization.

Observation:

• A case of a 71-year-old male with metastatic lung cancer and fatal lactic acidosis is presented.
• The patient had no liver involvement, which is unusual for solid tumor-associated lactic acidosis.
• Literature review identified only 27 cases of solid tumors with lactic acidosis, mostly with extensive liver metastasis.

Findings:

• Metastatic lung cancer can cause lactic acidosis without liver metastasis.
• Standard treatments like fluid resuscitation, bicarbonate, and hemodialysis were insufficient.
• Early, aggressive chemotherapy was the only effective intervention.

Implications:

• This case highlights a rare presentation of lactic acidosis in solid tumors.
• It underscores the importance of considering lactic acidosis in cancer patients, irrespective of liver status.
• Aggressive chemotherapy should be considered as a primary treatment for such cases.