Projevy, symptomy

Cell tumor lysys syndrome

• The cellular death and lysis that occurs
• Efflux of potassium, phosphorus, and uric acid
• Leading to organ dysfunction
• Derangements that include renal failure, cardiac arrhythmias, central nervous system toxicity,
• Death if not treated promptly
• TLS can be of two types:
• Laboratory TLS (LTLS),
• no clinical symptoms associated with laboratory abnormalities,
• Clinical TLS (CTLS),
• Concomitant clinical symptoms related to laboratory abnormalities.

LTLS is defined as the presence of two or more:

• uric acid over 8 mg/dL or 25% increase from baseline
• Potassium over 6.0 mEq/L or 25% increase from baseline
• Phosphorus
• Over 4.5 mg/dL (1.45 mmol/L) for adults
• Over 2.1 mmol/L (6.5 mg/dL) for children
• Or 25% increase from baseline
• calcium over 1.75 mmol/L or 25% decrease from baseline
• Occurring three days before or seven days after initiation of cytotoxic therapy

CTLS denotes the presence of

• LTLS
• One of the following markers of organ dysfunction, not believed to be attributable to chemotherapy
• Increased serum creatinine concentration 1.5 times the upper limit of normal
• Cardiac arrhythmia,
• Sudden death
• Seizures

• Total of 12 case reports of TLS
• 3 case reports of STLS in small cell lung cancer (SCLC)
• After extensive literature search in the English language
• Additional case report of TLS in mixed SCLC
• Non small cell lung cancer (NSCLC)
• All of the cases had metastasis at the time of presentation
• Onset of TLS ranged from one day to eight days after chemotherapy.
• www.cureus.com/articles/6156-spontaneous-tumor-lysis-syndrome-in-small-cell-lung-cancer#!/

Chemo side effects

• Nausea
• Vomiting
• Hair loss
• Fatigue
• Decreased blood cell counts
• Increased susceptibility to infections
• Changes in appetite
• Constipation or diarrhea
• Changes in mood, libido, and weight

• Chest discomfort or pain.
• A cough that doesn’t go away or gets worse over time.
• Trouble breathing.
• Wheezing.
• Blood in sputum (mucus coughed up from the lungs).
• Hoarseness.
• Trouble swallowing.
• Loss of appetite.
• Weight loss for no known reason.
• Feeling very tired.
• Swelling in the face and/or veins in the neck.
• Symptoms may result from local invasion or compression of adjacent thoracic structures,
• Esophagus causing dysphagia
• Compression involving the laryngeal nerves causing hoarseness
• Compression involving the superior vena cava causing facial edema and distension of the superficial veins of the head and neck.
• Symptoms from distant metastases
• Neurological defect
• Personality change from brain metastases
• Pain from bone metastases.

• Inappropriate antidiuretic hormone secretion.
• Cushing syndrome from secretion of adrenocorticotropic hormone.
• Paraneoplastic cerebellar degeneration.
• Lambert-Eaton myasthenic syndrome.[2]
• Enlarged supraclavicular lymphadenopathy
• Pleural effusion or lobar collapse
• Unresolved pneumonia
• Chronic obstructive pulmonary disease
• www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq

Relapsing polychondritis

• 57-year-old female presented with cough, expectoration, and fever
• (CT) scan performed at the hospital revealed diffuse thickening of bronchial walls in both lungs
• Bronchoscopy revealed that the tracheal mucosa was thickened, narrowed, and collapsed,
• Bronchoscope could pass through.
• Needle biopsy: considering small cell carcinoma in combination with immunohistochemical results.
• Symptom was not improved after anti-infective therapy.
• Left auricle was red and swollen, the auricle collapsed,
• Left eye had subconjunctival hemorrhage during her hospitalization without obvious cause
• Pulmonary small cell lung cancer cT0N2Mx rumen lymph node metastasis and RP were considered

Treatment

• Prednisone, orally for RP.
• Chemotherapy combined with radiotherapy was given for small cell lung cancer.
• Carboplatin combined with etoposide.
• The patient has already been followed for 1 year after receiving chemoradiotherapy
• Condition of the patient is stable at present.
• Symptoms such as auricle chondritis, ocular inflammatory disease, and nasal chondritis
• Should pay great attention to whether the case is caused by lung cancer with relapsing polychondritis
• Recognition of the disease in order to strive for early diagnosis and therapy.