• Ranjit Nair and Usman Shah.
• Department of Hematology and Oncology, Lehigh Valley Health Network, John and Dorothy Morgan Cancer Center, Allentown, Pennsylvania. Electronic address: ranjit_r.nair@lvhn.org.
• Am. J. Med. Sci. 2017 Apr 1; 353 (4): 402-406.

AbstractLactic acidosis is a potentially life-threatening complication characterized by accumulation of blood lactate resulting in low arterial pH. The majority of lactic acidosis in malignancies are reported in association with hematologic malignancies. It may result from an imbalance between lactate production and hepatic lactate utilization, but the exact pathophysiology is far more complex than what we can fathom from current micromolecular studies. We report a case of a 71-year-old male with metastatic lung cancer presenting with fatal lactic acidosis in the absence of liver involvement. Review of the literature reveals only 27 reported cases of solid tumors presenting with lactic acidosis, of which nearly all of them had extensive liver metastasis. Patients were treated with aggressive fluid resuscitation, bicarbonate administration and hemodialysis, but the only effective treatment modality was early aggressive chemotherapy initiation.Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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