Fatal Tumor Lysis Syndrome Induced by Pembrolizumab in Advanced Renal Pelvis Cancer

Tumor lysis syndrome (TLS) arises from the rapid breakdown of tumor cells during oncological treatment. Although TLS is rarely observed in solid tumors, few studies have documented instances of TLS associated with pembrolizumab. This report presents a case involving pembrolizumab-induced TLS.

A 76-year-old male patient with advanced renal pelvis cancer (T3N2M1) was treated with pembrolizumab as second-line therapy. Four days after the initiation of therapy, the patient developed TLS. Despite intensive therapeutic interventions, he succumbed to the condition on the 10th day.

This case highlights a fatal TLS episode after pembrolizumab. Given its poor prognosis, blood monitoring and prophylaxis are warranted in intermediate-risk patients, particularly when multiple non-renal risk factors are present.