Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
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Case Report

Volume 10, Number 1, January 2019, pages 24-26

Spontaneous Tumor Lysis Syndrome: A Rare Presentation in Breast Cancer


Table 1. Cairo-Bishop Definition of Laboratory Tumor Lysis Syndrome
VariableValueChange from baseline value
Adapted from Cairo et al [4].
Uric acid> 8 mg/dL25% increase
Potassium> 6 mEq/L25% increase
Phosphorus> 4.5 mg/dL in adults25% increase
Calcium< 7 mg/dL25% decrease


Table 2. Cairo-Bishop Grading of Clinical Tumor Lysis Syndrome for Adults
VariableGrade 0Grade 1Grade 2Grade 3Grade 4Grade 5
Adapted from Cairo et al [4]. ULN: upper limit of normal.
CreatineNone1.5 times ULN> 1.5 - 3.0 times ULN> 3.0 - 6.0 times ULN> 6.0 times ULNDeath
Cardiac arrhythmiaNoneIntervention not indicatedNon-urgent medical intervention indicatedSymptomatic and incompletely controlled medically or controlled with device (e.g., defibrillator)Life-threatening (e.g., arrhythmia associated with heart failure (HF), hypotension, syncope, shock).Death
SeizureNone-One brief, generalized seizure; seizure(s) well controlled by anticonvulsants or infrequent focal motor seizures not interfering with ADLSeizure in which consciousness is altered; poorly controlled seizure disorder; with breakthrough generalized seizures despite medical interventionSeizure of any kind which are prolonged, repetitive or difficult to control (e.g., status epilepticus, intractable epilepsy)Death