PDF(Pubmed)
Abstract：
We present a case of a man in his 70s who presented with worsening rectal and back pain associated with weight loss, dyspnoea and brownish discolouration of urine. Physical examination noted abdominal distention and epigastric tenderness. Laboratory investigations revealed acute kidney injury, hyperkalaemia, hyperphosphataemia and hyperuricaemia. Contrast CT of the abdomen/pelvis showed multiple, low-density masses throughout the liver, suspicious for metastatic disease. Oesophagogastroduodenoscopy demonstrated a large, fungating, infiltrative and ulcerated mass in the gastric body and lesser curvature of the stomach. Surgical pathology confirmed invasive moderately differentiated gastric adenocarcinoma. He met both the laboratory and clinical criteria for spontaneous tumour lysis syndrome (STLS) as per the Cairo-Bishop criteria. He was managed with aggressive fluid hydration, rasburicase and allopurinol, resulting in improvement in his renal function and laboratory findings. STLS of solid organ tumours, especially gastric adenocarcinoma, is rare and requires early detection with timely management to ensure favourable outcomes.
摘要：
我们介绍了一个70多岁的男人，他表现出与体重减轻相关的直肠和背痛恶化，呼吸困难和尿液褐色变色。体格检查发现腹胀和上腹部压痛。实验室检查显示急性肾损伤,高钾血症,高磷酸盐血症和高尿酸血症。腹部/骨盆造影CT显示多发，整个肝脏的低密度肿块，怀疑是转移性疾病。食管胃十二指肠镜检查显示，fungating,胃体的浸润和溃疡肿块和胃的较小曲率。手术病理证实为浸润性胃中分化腺癌。他符合Cairo-Bishop标准的自发性肿瘤溶解综合征（STLS）的实验室和临床标准。他接受了积极的液体水合治疗，rasburicase和别嘌呤醇，导致他的肾功能和实验室检查结果得到改善。实体器官肿瘤的STLS，尤其是胃腺癌,是罕见的，需要及早发现，及时管理，以确保有利的结果。
