What can trigger tumor lysis syndrome?

Tumor lysis syndrome (TLS) is a potentially life-threatening condition that occurs when cancer cells die rapidly and release their contents into the bloodstream. This usually happens after treatments such as chemotherapy, but it can also occur spontaneously in patients with highly proliferative tumors, particularly hematological malignancies like leukemia and lymphoma. Rapid tumor cell proliferation leads to an overwhelming release of intracellular ions and metabolites, including potassium, phosphate, and nucleic acids into the bloodstream, contributing to metabolic disturbances that can cause complications such as renal failure, cardiac arrhythmias, and seizures.

In this context, rapid tumor cell proliferation is directly linked to the pathophysiology of tumor lysis syndrome, making it the primary trigger. The other options do not accurately represent triggers for TLS: excessive hydration is typically a preventive measure against TLS complications; high calcium levels can be a separate issue related to malignancy but do not trigger TLS; and chronic liver disease may affect overall metabolism but is not a direct cause of TLS.