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Review
. 2023 Dec 10;59(12):2144.
doi: 10.3390/medicina59122144.

Afatinib-Induced Tumor Lysis Syndrome in Pulmonary Adenocarcinoma: A Case Report and Literature Review

Goohyeon Hong  1
Affiliations
Review

Afatinib-Induced Tumor Lysis Syndrome in Pulmonary Adenocarcinoma: A Case Report and Literature Review

Goohyeon Hong. Medicina (Kaunas). .

Abstract

Tumor lysis syndrome (TLS) is a potentially fatal oncological emergency that typically develops during the treatment of rapidly proliferating malignancies. It is infrequently reported in solid tumors, such as pulmonary adenocarcinoma. A 59-year-old male patient with shortness of breath presented with a 3.3 cm × 3.0 cm mass in the right upper lobe, along with massive right-sided pleural effusion. A percutaneous needle biopsy was performed, and a diagnosis of pulmonary adenocarcinoma with an epidermal growth factor receptor (EGFR) mutation was made. The patient was treated with afatinib because of the malignant pleural effusion and multiple metastases to the intrathoracic lymph nodes, left scapula, and brain. After 4 days of afatinib treatment, he developed oliguric acute kidney injury and progressively worsening dyspnea. Based on the clinical and laboratory findings, the patient was diagnosed with afatinib-induced TLS. To the best of our knowledge, this is the first reported case of afatinib-induced TLS in pulmonary adenocarcinoma.

Keywords: afatinib; pulmonary adenocarcinoma; targeted therapy; tumor lysis syndrome.

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Conflict of interest statement

Conflict of interest relevant to this article were not reported.

Figures

Figure 1
Figure 1
Initial chest radiography and post-drainage chest computed tomography showing a right-sided pleural effusion. (A) Chest radiography revealed a massive right-sided pleural effusion. (B) After drainage of the right-sided pleural effusion, chest computed tomography showed a 3.3 cm × 3.0 cm mass in the right upper lobe.
Figure 1
Figure 1
Initial chest radiography and post-drainage chest computed tomography showing a right-sided pleural effusion. (A) Chest radiography revealed a massive right-sided pleural effusion. (B) After drainage of the right-sided pleural effusion, chest computed tomography showed a 3.3 cm × 3.0 cm mass in the right upper lobe.
Figure 2
Figure 2
(A–E) Positron emission tomography/computed tomography revealed metastases to multiple lymph nodes, includingleft supraclavicular lymph node, bilateral mediastinal areas, and left scapula.
Figure 2
Figure 2
(A–E) Positron emission tomography/computed tomography revealed metastases to multiple lymph nodes, includingleft supraclavicular lymph node, bilateral mediastinal areas, and left scapula.
Figure 2
Figure 2
(A–E) Positron emission tomography/computed tomography revealed metastases to multiple lymph nodes, includingleft supraclavicular lymph node, bilateral mediastinal areas, and left scapula.
Figure 3
Figure 3
Magnetic resonance imaging of the brain revealed (A,B) multiple tiny cerebral and (C) right cerebellar metastases.
Figure 3
Figure 3
Magnetic resonance imaging of the brain revealed (A,B) multiple tiny cerebral and (C) right cerebellar metastases.
Figure 3
Figure 3
Magnetic resonance imaging of the brain revealed (A,B) multiple tiny cerebral and (C) right cerebellar metastases.
See this image and copyright information in PMC

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