Acute tumor lysis syndrome after transarterial chemoembolization for well-differentiated hepatocellular carcinoma with neuroendocrine features.

BACKGROUND: Acute tumor lysis syndrome (ATLS) was gradually considered as a separate entity or condition associated with bulk tumor treatment. There are few reports of ATLS following transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Primary HCCs with neuroendocrine features are also extremely rare. CASE REPORT: We report such a rare case of well-differentiated (WD)-HCC with neuroendocrine features, which presented with ATLS after TACE. The patient was a 54-year-old female. Needle biopsy of the liver histologically confirmed WD-HCC. On the 5th postoperative day, the patient was identified as having ATLS. Hemodialysis was done while her renal functions recovered. In the follow-up visits, computed tomography results showed distinct reduction in tumor size.
CONCLUSIONS: When a large HCC with rich blood supply undergoes TACE, we should pay attention to the possibility of ATLS. Close monitoring after antineoplastic therapy in high-risk patients is warranted.