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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
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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 - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Andrew Kent - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Yunan Nie - Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Jennifer Doran - Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Katherine Mayer - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Sandhya Sharma - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor 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.
