Background: Tumor lysis syndrome (TLS) is a major life-threatening oncological emergency where accelerated damage of rapidly proliferating tumor cells results in critical metabolic derangements including hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia potentially leading to acute kidney injury (AKI) and multi-organ failure. TLS has been well documented in hematologic malignancies but is extremely rare in solid neoplasms, [...]

Case Presentation: A 2-year-old girl with a past medical history of hypertension and anterior mediastinal mass of unclear etiology presents to the ED with acute bruising. 2 months prior, she was admitted to PICU for fever and lethargy, AKI, hyperuricemia and electrolyte abnormalities concerning for tumor lysis syndrome (TLS), and was found to have a [...]

Case Presentation: A 60-year-old male patient who presented with hemoptysis 1-year prior, was found to have sub-centimeter lung nodules and multiple liver lesions on CT chest. The largest hepatic lesion on abdominal MRI was 3.2 x 1.4cm. He declined liver biopsy and presented a year later with abdominal distension, early satiety and unintentional weight loss [...]

Case Presentation: An 81-year-old man with a history of heart failure (HF) and recent diagnosis of an ileocecal mass with associated bulky lymphadenopathy and peritoneal carcinomatosis (Figure 1) presented to the emergency room with decreased appetite, abdominal pain, and worsening abdominal distention. Upon arrival, the patient was afebrile and hemodynamically stable. Physical examination was remarkable [...]

Case Presentation: A 46-year-old male with a history of HFpEF on Entresto presented for fatigue, lymphadenopathy, and severe back pain. He was diagnosed with Renal Cell Carcinoma (RCC) and was pending oncologic evaluation. On admission, his potassium and platelet levels were within normal limits. However, within the next two weeks, those levels would rise. Potassium [...]

Case Presentation: A 65 year-old man was admitted overnight from the Emergency Department to a hospitalist service with oliguric acute kidney injury and abdominal pain. Past medical history includes a recently diagnosed metastatic melanoma. He had a very large tumor burden throughout the liver and abdomen and had not undergone any treatment yet. Physical examination [...]

Case Presentation: A 61-year-old male presented with complaint of left arm swelling with left axillary lump, which had been worsening for two months. He reported of having a dark-colored left forearm skin lesion which he reportedly removed by himself 15 years ago without seeking medical care. Computed Tomography of chest revealed too numerous to count [...]

Case Presentation: Hyperkalemia is common in patients with hematological malignancies due to tumor lysis syndrome (TLS). Hyperkalemia can be further complicated by presence of pseudo-hyperkalemia in these patients. Accurate potassium measurement is critical as over-correction in the setting of hyperkalemia can lead to iatrogenic hypokalemia. A 38-year-old male presented to the Emergency Department for fatigue, [...]

Case Presentation: A 38-year-old woman with suspected metastatic right breast cancer presented to the acute care hospital for a second opinion. The patient first noticed a breast lump one year ago and had been receiving homeopathic medical care without improvement. She was evaluated in a foreign country one week prior to admission and was advised [...]

Case Presentation: A 39-year-old male presented with persistent abdominal pain and was found to have a large, left-sided renal mass measuring 15 x 11 x 23 cm. Initial biopsy results were inconclusive, demonstrating nonspecific necrosis and inflammation. Two weeks later the patient developed worsening abdominal distention and acute kidney injury. He was found to have [...]