Spontaneous tumor lysis syndrome in a patient with metastatic prostate cancer

Tumor lysis syndrome (TLS) is a life-threatening oncological emergency, with most cases occurring in hematological malignancies following the initiation of treatment. However, on rare occasions, TLS may occur in solid tumors as well. In the present case study, the case is reported of a 56-year-old African-American man who presented with a recent diagnosis of prostate cancer, abdominal pain, elevated transaminases, renal insufficiency, hyperkalemia, and hyperuricemia, consistent with spontaneous TLS in the setting of metastatic prostate cancer. A computed tomography scan of the patient's abdomen demonstrated diffuse metastatic tumor burden. Following treatment with allopurinol, rasburicase, and initiation of anti-androgen therapy for the prostate cancer, the patient's TLS laboratory results normalized, however, his renal functions continued to decline. TLS is rare in solid tumors, and particularly rare in prostate cancer, with only six other case reports of the syndrome occurring to the best of our knowledge. This case report highlights the need for early recognition of TLS, even in cases that are not typically associated with the syndrome, as prompt diagnosis will affect early management and may be able to prevent or minimize complications.