Please cite this article in press as: Agarwala R, et al. Spontaneous tumour lysis syndrome in hepatocellular carcinoma presenting with hypocalcemic tetany: An unusual case and systematic literature review. Clin Res Hepatol Gastroenterol (2016), http://dx.doi.org/10.1016/j.clinre.2016.09.003 ARTICLE IN PRESS +Model CLINRE-924; No. of Pages 3 Clinics and Research in Hepatology and Gastroenterology (2016) xxx, xxx.e1—xxx.e3 Available online at ScienceDirect www.sciencedirect.com CASE REPORT Spontaneous tumour lysis syndrome in hepatocellular carcinoma presenting with hypocalcemic tetany: An unusual case and systematic literature review Roshan Agarwala a , Akash Batta b , Varun Suryadevera b , Vivek Kumar c , Vishal Sharma a,* , Surinder Singh Rana a a Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, India b Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, India c Department of Nephrology, Postgraduate Institute of Medical Education and Research, India Summary Tumour lysis syndrome is an oncological emergency which is usually seen following chemotherapy for rapidly proliferating haematological malignancies. Spontaneous tumour lysis syndrome is rare in solid tumour and even rarer with hepatocellular carcinoma (HCC). Tumour lysis syndrome in the setting of HCC is usually reported as a consequence of therapeutic inter- ventions like sorafenib administration or trans-arterial chemoembolization. We report about a case of a young lady with chronic hepatitis B related HCC who developed spontaneous tumour lysis syndrome and presented with hypocalcemic tetany. We also compare this case with the previously reported cases of spontaneous tumour lysis syndrome in hepatocellular carcinoma. © 2016 Elsevier Masson SAS. All rights reserved. Introduction Tumour lysis syndrome (TLS) is an oncological emer- gency that results from rapid destruction of malignant * Corresponding author at: Department of Gastroenterology, Post- graduate Institute of Medical Education and Research, Chandigarh, India. Tel.: +91 7087008099. E-mail address: docvishalsharma@gmail.com (V. Sharma). cells which can cause hyperuricemia, hyperkalemia, hyper- phosphatemia, hypocalcemia and renal failure [1]. It is predominantly seen after the initiation of chemotherapy in haematological malignancies, and is relatively infrequent with solid tumours [2]. Rarely rapid destruction of cells can occur spontaneously without preceding chemotherapy, a condition known as spontaneous tumour lysis syndrome (STLS). STLS is exceedingly rare in hepatocellular carcinoma (HCC). Here we report a case of metastatic HCC who pre- sented with tetany and was diagnosed as having STLS. http://dx.doi.org/10.1016/j.clinre.2016.09.003 2210-7401/© 2016 Elsevier Masson SAS. All rights reserved.