内容紹介
Gemcitabine-Induced Tumor Lysis Syndrome Caused by Recurrent Breast Cancer in a Patient without Hemodialysis
Summary
Tumor lysis syndrome(TLS)induced by chemotherapy for solid tumors is rare. We report a case of a 59-year-old woman with breast cancer who developed TLS. She underwent surgery to treat breast cancer in 1992. 19 years after surgery, however, she was diagnosed with multiple bone metastases(disease free interval, 13 years and 3 months). In March 2011, gemcitabine regimen was initiated(1,250 mg/m2, 14 days followed by a 7-day rest period)because of worsening of multiple bone metastases. The patient was immediately admitted and treated for suspected TLS when she presented at our hospital with symptoms such as depressed level of consciousness, serious anemia, hypercalcemia, hyperuricemia, and liver/renal dysfunction on day 16 of the first line of regimen. Rasburicase was found to be effective for hyperuricemia.
要旨
乳癌患者でTLSを来した症例を報告する。症例は59歳,女性。乳癌に対し1992年に手術を施行した。術後19年目(DFI 13年3か月)で多発骨転移を認めた。2011年3月,多発骨転移が増悪しゲムシタビン(2投1休1,250 mg/m2)開始。1コース目day 16に意識レベルの低下,高度貧血,高Ca血症,高尿酸血症,肝・腎機能障害が出現し緊急入院,TLSを疑い治療を行った。高尿酸血症に対しラスブリカーゼが有効であった。固形癌の化学療法によるTLSの発症はまれであるため報告する。
目次
Summary
Tumor lysis syndrome(TLS)induced by chemotherapy for solid tumors is rare. We report a case of a 59-year-old woman with breast cancer who developed TLS. She underwent surgery to treat breast cancer in 1992. 19 years after surgery, however, she was diagnosed with multiple bone metastases(disease free interval, 13 years and 3 months). In March 2011, gemcitabine regimen was initiated(1,250 mg/m2, 14 days followed by a 7-day rest period)because of worsening of multiple bone metastases. The patient was immediately admitted and treated for suspected TLS when she presented at our hospital with symptoms such as depressed level of consciousness, serious anemia, hypercalcemia, hyperuricemia, and liver/renal dysfunction on day 16 of the first line of regimen. Rasburicase was found to be effective for hyperuricemia.
要旨
乳癌患者でTLSを来した症例を報告する。症例は59歳,女性。乳癌に対し1992年に手術を施行した。術後19年目(DFI 13年3か月)で多発骨転移を認めた。2011年3月,多発骨転移が増悪しゲムシタビン(2投1休1,250 mg/m2)開始。1コース目day 16に意識レベルの低下,高度貧血,高Ca血症,高尿酸血症,肝・腎機能障害が出現し緊急入院,TLSを疑い治療を行った。高尿酸血症に対しラスブリカーゼが有効であった。固形癌の化学療法によるTLSの発症はまれであるため報告する。