Tumor lysis syndrome in premature infant prompting early resection of a large sacrococcygeal teratoma: a case report.
Glucocorticoids
Hyperkalemia
Neonate
Premature infant
Premature neonates
Rasburicase
Sacrococcygeal teratoma
Tumor lysis syndrome
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
02 09 2023
02 09 2023
Historique:
received:
18
05
2022
accepted:
17
07
2023
medline:
4
9
2023
pubmed:
3
9
2023
entrez:
2
9
2023
Statut:
epublish
Résumé
Sacrococcygeal teratomas (SCTs) are the most common congenital neoplasm and often require resection soon after birth. There are rare reports of cardiac arrest during surgery due to manipulation of the tumor triggering secondary necrosis and hyperkalemia. This case describes a very preterm infant with a SCT who develops spontaneous preoperative tumor lysis syndrome (TLS). The medical team utilized rasburicase and the patient underwent total gross resection at 40 h of life. We emphasize the importance of the early recognition and management of tumor lysis syndrome in SCT with rasburicase, aggressive management of hyperkalemia and consideration of early resection of SCTs even in the case of a very premature infant.
Sections du résumé
BACKGROUND
Sacrococcygeal teratomas (SCTs) are the most common congenital neoplasm and often require resection soon after birth. There are rare reports of cardiac arrest during surgery due to manipulation of the tumor triggering secondary necrosis and hyperkalemia.
CASE PRESENTATION
This case describes a very preterm infant with a SCT who develops spontaneous preoperative tumor lysis syndrome (TLS). The medical team utilized rasburicase and the patient underwent total gross resection at 40 h of life.
CONCLUSIONS
We emphasize the importance of the early recognition and management of tumor lysis syndrome in SCT with rasburicase, aggressive management of hyperkalemia and consideration of early resection of SCTs even in the case of a very premature infant.
Identifiants
pubmed: 37660010
doi: 10.1186/s12887-023-04193-w
pii: 10.1186/s12887-023-04193-w
pmc: PMC10474622
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
440Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Lahdes-Vasama TT, Korhonen PH, Seppänen JM, Tammela OK, Iber T. Preoperative embolization of giant sacrococcygeal teratoma in a premature newborn. J Pediatr Surg. 2011;46(1):5.
doi: 10.1016/j.jpedsurg.2010.09.038
Abraham E, Parray T, Ghafoor A. Complications with massive sacrococcygeal tumor resection on a premature neonate. J Anesth. 2010;24(6):951–4.
doi: 10.1007/s00540-010-1027-x
pubmed: 21057822
Tran KM, Flake AW, Kalawadia NV, Maxwell LG, Rehman MA. Emergent excision of a prenatally diagnosed sacrococcygeal teratoma. Paediatr Anaesth. 2008;18(5):431–4.
doi: 10.1111/j.1460-9592.2008.02450.x
pubmed: 18312529
Jona JZ. Progressive tumor necrosis and lethal hyperkalemia in a neonate with sacrococcygeal teratoma (SCT). J Perinatol. 1999;19(7):538–40.
doi: 10.1038/sj.jp.7200197
pubmed: 10685309
Makin EC, Hyett J, Ade-Ajayi N, Patel S, Nicolaides K, Davenport M. Outcome of antenatally diagnosed sacrococcygeal teratomas: single-center experience (1993–2004). J Pediatr Surg. 2006;41(2):388–93.
doi: 10.1016/j.jpedsurg.2005.11.017
pubmed: 16481257
Kim JW, Gwak M, Park JY, Kim HJ, Lee YM. Cardiac arrest during excision of a huge sacrococcygeal teratoma - A report of two cases -. Korean J Anesthesiol. 2012;63(1):80–4.
doi: 10.4097/kjae.2012.63.1.80
pubmed: 22870372
pmcid: 3408522
Holterman AX, Filiatrault D, Lallier M, Youssef S. The natural history of sacrococcygeal teratomas diagnosed through routine obstetric sonogram: a single institution experience. J Pediatr Surg. 1998;33(6):899–903.
doi: 10.1016/S0022-3468(98)90670-4
pubmed: 9660225
Abraham E, Parray T, Ghafoor A. Complications with massive sacrococcygeal tumor resection on a premature neonate. J Anesth. 2010;24(6):951–4.
doi: 10.1007/s00540-010-1027-x
pubmed: 21057822
Reinoso-Barbero F, Sepulveda I, Pérez-Ferrer A, De Andres A. Cardiac arrest secondary to hyperkalemia during surgery for a neonatal giant sacrococcygeal teratoma. Paediatr Anaesth. 2009;19(7):712–4.
doi: 10.1111/j.1460-9592.2009.03049.x
pubmed: 19638127
Cairo MS, Coiffier B, Reiter A, Younes A. TLS Expert Panel. Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: an expert TLS panel consensus. Br J Haematol. 2010;149(4):578–86.
doi: 10.1111/j.1365-2141.2010.08143.x
pubmed: 20331465
Coiffier B, Altman A, Pui C, Younes A, Cairo MS. Guidelines for the management of pediatric and adult tumor lysis syndrome: an evidence-based review. J Clin Oncol. 2008;26(16):2767–78.
doi: 10.1200/JCO.2007.15.0177
pubmed: 18509186
Matsushita FY, Krebs VLJ, Ferraro AA, de Carvalho WB. Early fluid overload is associated with mortality and prolonged mechanical ventilation in extremely low birth weight infants. Eur J Pediatr. 2020;179(11):1665–71.
doi: 10.1007/s00431-020-03654-z
pubmed: 32382790
Wyrebek R, Mohammad A, Iqbal A, Dighe D, Giordano L. Treatment of metabolic abnormalities with rasburicase in a premature neonate. Arch Clin Cases. 2018;5(2):37–41.
McNutt DM, Holdsworth MT, Wong C, Hanrahan JD, Winter SS. Rasburicase for the management of tumor lysis syndrome in neonates. Ann Pharmacother. 2006;40(7–8):1445–50.
doi: 10.1345/aph.1G670
pubmed: 16868218
Zaramella P, De Salvia A, Zaninotto M, Baraldi M, Capovilla G, De Leo D, et al. Lethal effect of a single dose of rasburicase in a preterm newborn infant. Pediatrics. 2013;131(1):309.
doi: 10.1542/peds.2011-1580
Ponmudi N, Beryl S, Santhanam S, Beck M. Tumour lysis in newborn: Spontaneous or secondary to antenatal steroids?. BMJ Case Rep. 2018:bcr–2017. https://doi.org/10.1136/bcr-2017-223107 .
Kim JO, Jun DW, Tae HJ, Lee KN, Lee HL, Lee OY, et al. Low-dose steroid-induced tumor lysis syndrome in a hepatocellular carcinoma patient. Clin Mol Hepatol. 2015;21(1):85–8.
doi: 10.3350/cmh.2015.21.1.85
pubmed: 25834806
pmcid: 4379202