Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma

Introduction: Spontaneous tumor lysis syndrome (TLS) is a rare, life-threatening metabolic complication that typically occurs in malignancies with high tumor burden. Early recognition is critical, even in the absence of a known malignancy, to prevent severe outcomes. Case Presenta...

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Main Authors: Feehaan H. Sultan, Priya K. Jindal, Zeeshaan H. Sultan, Nahush R. Bansal, Shuhao Qiu
Format: Article
Language:English
Published: Karger Publishers 2025-02-01
Series:Case Reports in Oncology
Online Access:https://karger.com/article/doi/10.1159/000544865
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author Feehaan H. Sultan
Priya K. Jindal
Zeeshaan H. Sultan
Nahush R. Bansal
Shuhao Qiu
author_facet Feehaan H. Sultan
Priya K. Jindal
Zeeshaan H. Sultan
Nahush R. Bansal
Shuhao Qiu
author_sort Feehaan H. Sultan
collection DOAJ
description Introduction: Spontaneous tumor lysis syndrome (TLS) is a rare, life-threatening metabolic complication that typically occurs in malignancies with high tumor burden. Early recognition is critical, even in the absence of a known malignancy, to prevent severe outcomes. Case Presentation: We report the case of an 89-year-old male with a history of chronic kidney disease, hyperparathyroidism, and myasthenia gravis, who experienced three episodes of TLS within 1 month. Initially, his metabolic disturbances were misattributed to dehydration. During his second admission, imaging revealed extensive lymphadenopathy, and a lymph node biopsy confirmed follicular helper T-cell lymphoma before his third hospitalization. Despite aggressive treatment, he developed metabolic encephalopathy and lost his decision-making capacity, while his family declined palliative care discussions. Conclusion: This case highlights the importance of considering TLS in patients with unexplained hyperkalemia, hyperuricemia, and hyperphosphatemia, even in the absence of a malignancy diagnosis. Early diagnosis and multidisciplinary care are essential to improve outcomes.
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series Case Reports in Oncology
spelling doaj-art-e7def169f7ce4a81ab300ec37b12b07e2025-08-20T01:51:04ZengKarger PublishersCase Reports in Oncology1662-65752025-02-0118141341910.1159/000544865Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell LymphomaFeehaan H. SultanPriya K. JindalZeeshaan H. SultanNahush R. BansalShuhao Qiu Introduction: Spontaneous tumor lysis syndrome (TLS) is a rare, life-threatening metabolic complication that typically occurs in malignancies with high tumor burden. Early recognition is critical, even in the absence of a known malignancy, to prevent severe outcomes. Case Presentation: We report the case of an 89-year-old male with a history of chronic kidney disease, hyperparathyroidism, and myasthenia gravis, who experienced three episodes of TLS within 1 month. Initially, his metabolic disturbances were misattributed to dehydration. During his second admission, imaging revealed extensive lymphadenopathy, and a lymph node biopsy confirmed follicular helper T-cell lymphoma before his third hospitalization. Despite aggressive treatment, he developed metabolic encephalopathy and lost his decision-making capacity, while his family declined palliative care discussions. Conclusion: This case highlights the importance of considering TLS in patients with unexplained hyperkalemia, hyperuricemia, and hyperphosphatemia, even in the absence of a malignancy diagnosis. Early diagnosis and multidisciplinary care are essential to improve outcomes. https://karger.com/article/doi/10.1159/000544865
spellingShingle Feehaan H. Sultan
Priya K. Jindal
Zeeshaan H. Sultan
Nahush R. Bansal
Shuhao Qiu
Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma
Case Reports in Oncology
title Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma
title_full Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma
title_fullStr Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma
title_full_unstemmed Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma
title_short Recurrent Spontaneous Tumor Lysis Syndrome in Undiagnosed Follicular T-Cell Lymphoma
title_sort recurrent spontaneous tumor lysis syndrome in undiagnosed follicular t cell lymphoma
url https://karger.com/article/doi/10.1159/000544865
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AT priyakjindal recurrentspontaneoustumorlysissyndromeinundiagnosedfolliculartcelllymphoma
AT zeeshaanhsultan recurrentspontaneoustumorlysissyndromeinundiagnosedfolliculartcelllymphoma
AT nahushrbansal recurrentspontaneoustumorlysissyndromeinundiagnosedfolliculartcelllymphoma
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