Oncologic Emergencies - Differential Diagnosis Framework HEMATOLOGIC ONCOLOGIC EMERGENCIES: Hyperviscosity Syndrome: • Spontaneous bleeding • Shortness of breath • Neurologic deficits (peripheral neuropathies) • "Sausage-like" hemorrhagic retinal veins, serum viscosity > 4 cP • 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°F) sustained over a one-hour period STRUCTURAL ONCOLOGIC EMERGENCIES:: Malignant Epidural Spinal Cord Compression: • New-onset back pain (worse when lying down) • Paraplegia (late presentation) Superior Vena Cava Syndrome: • Facial edema • Cough • 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 ONCOLOGIC EMERGENCIES: 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 #Oncologic #emergencies #oncology #differential #diagnosis #cancer
