Oncologic Emergencies

HEMATOLOGIC:

 • Hyperviscosity Syndrome: Spontaneous bleeding, Shortness of breath, Neurologic deficits (peripheral neuropathies), "Sausage-like" hemorrhagic retinal veins, Associated with Waldenström macroglobulinemia.

 • Leukostasis: WBC > 100,000 /mm3, Respiratory failure, Intracranial hemorrhage, Early death

 • Neutropenic Fever: Absolute neutrophil count < 500 cells /mm3, Single oral temperature of ≥38.3°C (101°F) or a ≥38.0° C (100.4°) sustained over a one-hour period

STRUCTURAL:

 • Malignant Epidural Spinal Cord Compression: New-onset back pain (worse when lying down), Paraplegia (late presentation)

 • Superior Vena Cava Syndrome: Facial edema, Dyspnea at rest, Hoarseness, Chest and shoulder pain, collateral venous circulation (chest wall)

 • Malignant Pericardial Effusion: Dyspnea, chest pain, or palpitations, Pulsus paradoxus, Beck triad (muffled heart sounds, hypotension increased jugular venous pressure)

METABOLIC:

 • Tumor Lysis Syndrome: Azotemia, Hyperphosphatemia, Hyperkalemia, Hyperuricemia, Acute renal failure, Hypocalcemia

 • Hypercalcemia of Malignancy: Progressive decline in mental function, Weakness, Anorexia, Thirst, Constipation, Nausea, Vomiting, decreased urine output, possible coma

 • SIADH: Hyponatremia, Nausea, vomiting, Constipation, Muscle weakness



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