Spontaneous tumor lysis syndrome in a case of B-cell non-Hodgkin's lymphoma

Tumor lysis syndrome (TLS) is a group of metabolic abnormalities that are usually seen in cancer patients treated with chemotherapy although it can occasionally occur spontaneously without chemotherapy in patients with a high tumor burden. It is due to the rapid lysis of tumor cells resulting in the release of large amounts of intracellular contents in the blood stream. This results in the rapid development of high levels of phosphate, potassium and uric acid accompanied by a profound decrease in serum calcium. TLS usually occurs in bulky tumors with a high turnover such as leukemias and lymphomas. The malignancy can be undiagnosed at the time of development of TLS [1]. In this report we present a case in which the patient presented with spontaneous TLS (STLS) and was later diagnosed with high-grade B-cell non-Hodgkin's lymphoma (NHL).