RT Book, Section A1 Gutierrez, Cristina A1 Pastores, Stephen M. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107722918 T1 Oncologic Emergencies T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accesssurgery.mhmedical.com/content.aspx?aid=1107722918 RD 2024/03/28 AB Respiratory, neurologic, metabolic, thoracic, and cardiac emergencies constitute life-threatening complications in patients with malignancies. These oncologic emergencies often result from the cancer itself and/or from treatment of the cancer.Increased activation of the coagulation system, administration of thrombogenic chemotherapy regimens, and placement of intravascular venous catheters place cancer patients at higher risk for pulmonary embolism and hemodynamic instability.Neurologic emergencies in cancer patients include status epilepticus, malignant spinal cord compression, and intracranial hemorrhage.Radiation therapy and corticosteroids are the mainstays of treatment of malignant spinal cord compression.Malignancy-associated hypercalcemia (MAH) can be divided into humoral, osteolytic, and calcitriol-associated hypercalcemia. Bisphosphonates are the most efficient and recommended treatment for MAH.Tumor lysis syndrome is associated with hyperuricemia, hyperphosphatemia, hypocalcemia, and hyperkalemia, which if left untreated can lead to arrhythmias and death. Treatment includes aggressive hydration, specific treatment of individual metabolic derangements, allopurinol or rasburicase, and hemodialysis for severe hyperphosphatemia and symptomatic hypocalcemia.Leukapheresis is usually initiated for the treatment of leukostasis associated with acute myelogenous leukemia if the WBC count >50,000/mm3 and in acute lymphoblastic leukemia if the WBC count is >250,000/mm3.Ninety percent of malignant causes of superior vena cava syndrome (SCVS) are due to lung cancer and lymphoma. Patients presenting with cerebral edema and airway compromise due to SVCS should be treated urgently and considered for SVC stenting.Treatment for cardiac tamponade requires emergent drainage by either pericardiocentesis or pericardial window.