When Rapid Response Becomes Catastrophic: Tumor Lysis Syndrome Following Cisplatin-Etoposide Therapy in Extensive-Stage Small Cell Lung Cancer.

Authors

Nickolle A Cruz Figueroa, Gerardo Martinez Arroyo, Gonzalo Martinez Ruiz, Jean C Rivera, Paloma Delgado, Mileidy Hernandez, Jose Torres Cintron

Published in

Cureus. Volume 18. Issue 5. Pages e109632. Epub May 25, 2026.

Abstract

Tumor lysis syndrome (TLS) is an oncologic emergency characterized by severe metabolic derangements resulting from rapid tumor cell breakdown. We present the case of a 66-year-old man with extensive-stage small cell lung cancer (SCLC) involving the mediastinum, pleura, and left upper lobe, who developed TLS shortly after initiation of cisplatin-etoposide chemotherapy. Laboratory evaluation demonstrated hyperuricemia, hyperkalemia, hyperphosphatemia, syndrome of inappropriate antidiuretic hormone secretion (SIADH)-related hyponatremia, and acute kidney injury, consistent with TLS. Imaging revealed extensive intrathoracic disease with a large left pleural effusion and mediastinal involvement. The patient required aggressive electrolyte management and close monitoring following chemotherapy initiation. This case emphasizes the importance of maintaining clinical suspicion for TLS in patients with bulky SCLC receiving cytotoxic therapy and highlights the need for early recognition and prompt intervention.

PMID:
42359180
Bibliographic data and abstract were imported from PubMed on 26 Jun 2026.

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