Abstract：
BACKGROUND: Tumor lysis syndrome is an oncologic emergency that involves multiple metabolic abnormalities and clinical symptoms such as acute renal failure, cardiac arrhythmias, seizures, and multiorgan failure, and may be fatal if not promptly recognized. Tumor lysis syndrome occurs most often in patients with hematologic malignancies, and relatively few cases have been described in patients with sarcoma.
METHODS: A 64-year-old male of Asian heritage presented to his primary care physician with a right lower-extremity mass and was ultimately diagnosed with widely metastatic osteosarcoma. He was treated with one cycle of cisplatin and doxorubicin that was complicated by hypervolemia and hypoxic respiratory failure. Given concerns for volume overload, therapy was changed to single-agent, dose-reduced ifosfamide. After receiving one dose of ifosfamide 1 g/m2 (1.8 g total) intravenously over 1 hour, the patient developed renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and lactic acidosis. The patient ultimately died from severe electrolyte abnormalities associated with tumor lysis syndrome.
CONCLUSIONS: This is the first instance of tumor lysis syndrome described in a patient with osteosarcoma undergoing ifosfamide monotherapy. Clinicians must be vigilant in identifying tumor lysis syndrome regardless of the malignancy type or chemotherapy regimen in order to prevent potentially fatal complications.
METHODS: A 64-year-old male of Asian heritage presented to his primary care physician with a right lower-extremity mass and was ultimately diagnosed with widely metastatic osteosarcoma. He was treated with one cycle of cisplatin and doxorubicin that was complicated by hypervolemia and hypoxic respiratory failure. Given concerns for volume overload, therapy was changed to single-agent, dose-reduced ifosfamide. After receiving one dose of ifosfamide 1 g/m2 (1.8 g total) intravenously over 1 hour, the patient developed renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and lactic acidosis. The patient ultimately died from severe electrolyte abnormalities associated with tumor lysis syndrome.
CONCLUSIONS: This is the first instance of tumor lysis syndrome described in a patient with osteosarcoma undergoing ifosfamide monotherapy. Clinicians must be vigilant in identifying tumor lysis syndrome regardless of the malignancy type or chemotherapy regimen in order to prevent potentially fatal complications.
摘要：
背景：肿瘤溶解综合征是一种涉及多种代谢异常和临床症状如急性肾功能衰竭的肿瘤急症，心律失常,癫痫发作,多器官衰竭,如果不及时识别，可能是致命的。肿瘤溶解综合征最常见于血液系统恶性肿瘤患者，并且在肉瘤患者中描述的病例相对较少。
方法：一名64岁的亚洲裔男性患者向其初级保健医生就诊，其右下肢肿块，最终被诊断为广泛转移性骨肉瘤。他接受了一个周期的顺铂和多柔比星治疗，并发高血容量和低氧性呼吸衰竭。考虑到体积过载，治疗改为单药，剂量减少的异环磷酰胺。在1小时内静脉注射1克/平方米（共1.8克）的异环磷酰胺后，病人出现肾衰竭,高尿酸血症,高钾血症,高磷酸盐血症,和乳酸性酸中毒.患者最终死于与肿瘤溶解综合征相关的严重电解质异常。
结论：这是在接受异环磷酰胺单药治疗的骨肉瘤患者中首次描述的肿瘤溶解综合征。无论恶性肿瘤类型或化疗方案如何，临床医生都必须警惕识别肿瘤溶解综合征，以防止潜在的致命并发症。
方法：一名64岁的亚洲裔男性患者向其初级保健医生就诊，其右下肢肿块，最终被诊断为广泛转移性骨肉瘤。他接受了一个周期的顺铂和多柔比星治疗，并发高血容量和低氧性呼吸衰竭。考虑到体积过载，治疗改为单药，剂量减少的异环磷酰胺。在1小时内静脉注射1克/平方米（共1.8克）的异环磷酰胺后，病人出现肾衰竭,高尿酸血症,高钾血症,高磷酸盐血症,和乳酸性酸中毒.患者最终死于与肿瘤溶解综合征相关的严重电解质异常。
结论：这是在接受异环磷酰胺单药治疗的骨肉瘤患者中首次描述的肿瘤溶解综合征。无论恶性肿瘤类型或化疗方案如何，临床医生都必须警惕识别肿瘤溶解综合征，以防止潜在的致命并发症。
