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Case Series
Spontaneous tumor lysis syndrome and hemophagocytic lymphohistiocytosis in metastatic melanoma: A case series and review of the literature
1 Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
2 Division of Medical Oncology, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
3 University of Colorado Comprehensive Cancer Center, Aurora, Colorado, USA
4 Department of Emergency Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
5 Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
6 Division of Medical Oncology, Denver Health Medical Center, Denver, Colorado, USA
Address correspondence to:
Natalie V Longino
12631 East 17th Avenue, Aurora, CO 80045,
USA
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Article ID: 100099Z10NL2021
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How to cite this article
Longino NV, Kent A, Nie Y, Doran J, Mayer K, Sharma S. Spontaneous tumor lysis syndrome and hemophagocytic lymphohistiocytosis in metastatic melanoma: A case series and review of the literature. J Case Rep Images Oncology 2021;7:100099Z10NL2021.ABSTRACT
Introduction: Tumor lysis syndrome (TLS) and hemophagocytic lymphohistiocytosis (HLH) are two medical emergencies associated with malignancy and treatment thereof. More commonly they are associated with treatment of fast growing and highly chemotherapy-responsive tumors such as lymphomas and small cell lung cancer. However, a growing body of evidence demonstrates they can occur with other malignancies, such as melanoma, and can happen spontaneously prior to treatment initiation.
Case Series: We describe two cases of patients with metastatic melanoma who experienced rapid progressive clinical decline prior to initiation of treatment for their metastatic disease. Laboratory findings at the time of presentation in both cases were consistent with TLS. The second case was further complicated by possible HLH, though diagnosis and treatment remained controversial among our team.
Conclusion: We hope these reports increase awareness of the risk of spontaneous TLS and HLH in metastatic melanoma, foster discussion of the difficulty of defining HLH, and shed light on their prognostic implications and management.
Keywords: Hemophagocytic lymphohistiocytosis, Melanoma, Tumor lysis syndrome
SUPPORTING INFORMATION
Acknowledgments
We thank the patient’s families who provided consent for publishing of this article and to the additional medical and support staff who helped provide care for these patients.
Author ContributionsNatalie V Longino - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Andrew Kent - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Yunan Nie - Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Jennifer Doran - Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Katherine Mayer - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sandhya Sharma - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Natalie V Longino et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
