RT Book, Section
A1 Yeung, Sai-Ching Jim
A1 Manzullo, Ellen F.
A1 Chaftari, Patrick
A2 Kantarjian, Hagop M.
A2 Wolff, Robert A.
A2 Rieber, Alyssa G.
SR Print(0)
ID 1190839903
T1 Oncologic Emergencies
T2 The MD Anderson Manual of Medical Oncology, 4e
YR 2022
FD 2022
PB McGraw Hill Education
PP New York, NY
SN 9781260467642
LK accessmedicine.mhmedical.com/content.aspx?aid=1190839903
RD 2024/04/16
AB KEY  CONCEPTSOncologic  emergencies  can  result  from  either  the  cancer  or  its  treatment.  This  chapter  discusses  some  selected  emergencies.Nervous  system  emergencies  include  spinal  cord  compression,  increased  intracranial  pressure,  leptomeningeal  disease,  seizures,  and  altered  mental  status.Superior  vena  cava  (SVC)  syndrome,  hyperviscosity  syndrome,  hyperleukocytosis,  venous  thromboembolism,  hemorrhage,  and  disseminated  intravascular  coagulopathy  are  the  vascular  and  hematologic  emergencies  discussed.Urologic  emergencies  such  as  hemorrhagic  cystitis  and  obstructive  uropathy  are  discussed.Pulmonary  problems  such  as  airway  obstruction,  massive  hemoptysis,  toxic  lung  injuries,  pneumonitis,  and  pulmonary  fibrosis  can  be  caused  by  cancer  or  cancer  treatments.Several  classic  metabolic  oncologic  emergencies  include  syndrome  of  inappropriate  antidiuretic  hormone  secretion,  tumor  lysis  syndrome,  and  hypercalcemia  of  malignancy.Gastrointestinal  bleeding  in  patients  with  cancer  and  typhlitis  in  patients  with  neutropenic  fever  are  potentially  serious  complications.Immune  checkpoint  inhibitors  may  cause  immune-related  adverse  effects  (irAEs)  in  practically  any  organ  system.  Urgent  skin  irAEs  include  grade  3  and  4  inflammatory  dermatitis  or  rash,  bullous  dermatosis,  drug  reaction  with  eosinophilia  and  systemic  symptoms,  and  Stevens-Johnson  syndrome  or  toxic  epidermal  necrolysis.  Gastrointestinal  irAEs  are  common.  The  main  pulmonary  irAE  is  pneumonitis.  Endocrine  irAEs  affect  the  thyroid,  adrenal,  and  pituitary  glands  as  well  as  the  pancreatic  islets  (type  1  diabetes),  which  may  be  associated  with  acute  diabetic  ketoacidosis.  Myocarditis  is  rare  but  may  be  life  threatening.  Pneumonitis  may  be  associated  with  poor  overall  survival.