Acute tumor lysis syndrome with squamous cell carcinoma of the vulva.

Acute tumor lysis syndrome (ATLS) is a rare metabolic complication in nonhematologic malignancies. We report a unique case of extensive regionally recurrent squamous cell carcinoma of the vulva who developed a picture compatible with ATLS 36 hr after the initiation of palliative chemotherapy. The patient suffered acute renal failure with hyperuricemia, hyperphosphatemia, and hypocalcemia as well as a picture suggestive of congestive heart failure. The patient responded well to adequate hydration, alkaline diuresis, and allopurinol. The potential for ATLS should be anticipated when treating metastatic or locally advanced squamous cell carcinoma of the vulva with chemotherapy.