Background: Tumor lysis syndrome is an unusual metabolic emergency in solid tumors. Perioperative occurrence of this syndrome is extremely rare but may have fatal consequences if not detected and treated on time.
Case report: We report a 19-year patient with testicular germ cell tumor after first line chemotherapy with giant growing teratoma syndrome in retroperitoneum. He underwent radical resection, however, perioperatively, a fatal case of heart failure due to unrecognized intraoperative tumor lysis syndrome developed.
Conclusion: Surgeons, anesthesiologists and oncologists should be aware of this complication in order to be prepared for such an emergency.
Keywords: Genitourinary neoplasm; Intraoperative; Necrosis; Surgery; Teratoma.