Tumor lysis syndrome associated with chemotherapy in primary retroperitoneal soft tissue sarcoma by ex vivo ATP-based tumor chemo-sensitivity assay (ATP-TCA)

Abstract

Tumor lysis syndrome (TLS), a result of rapid cell lysis following tumor therapy, is a well recognized complication during the treatment of rapidly growing tumors. TLS rarely occurs in solid tumors. We present a case report of TLS in a patient with primary retroperitoneal soft tissue sarcoma. TLS occurred in the patient after four days' combinational chemotherapy with cisplatin, adriamycin, and dacarbazine. These drugs were selected on the basis of an ex vivo ATP-based tumor sensitivity assay. TLS was properly controlled in the patient with concomitant remission of the sarcoma. Therefore, precautions should be taken to avoid this potentially fatal complication during treatment of solid tumors, especially with tumors highly sensitive to drugs.

Keywords: ATP-based tumor sensitivity assay (ATP-TCA); retroperitoneal soft tissue sarcoma; tumor lysis syndrome.

Figure 1

Magnetic resonance imaging (MRI) shows a bulky abdominal neoplasm at the left posterolateral position of abdomen with compression of kidney, renal artery and renal veins on the left side (A). MRI after 3 cycles of chemotherapy reveals complete remission of the tumor with cystic degeneration and necrosis of the tumor mass (B).

Figure 2

Histological analysis of the biopsy tumor specimen by .hematoxylin and eosin staining of the tumor (A, X100; B, X400) indicates diagnosis of primary retroperitoneal soft tissue sarcoma. The tumor samples were positive in immunohistochemical analysis for vimentin (C) and epithelial membrane antigen (D).