Refractory Hypoglycaemia in Hepatocellular Carcinoma Treated with TACE Leading to Tumour Lysis Syndrome- A Double Trouble

Hepatocellular Carcinoma (HCC) is the most common type of primary liver cancer. Hypoglycaemia is a well-established paraneoplastic manifestation of HCC. Cytoreduction by surgery or Transarterial Chemoembolisation (TACE) has been effective treatment options in such cases when conservative treatment fails. Tumour Lysis Syndrome (TLS) is an oncological emergency following treatment of malignancies with high cell turnover and can be seen in liver-directed therapy in the form of both ablative therapies and transarterial therapies for HCC. Authors present a rare case of 65-year-old male, with HCC presented with symptoms of refractory hypoglycaemia which was managed by TACE procedure with further patient developing TLS which was medically managed.