Oncological Emergencies Flashcards
SVC obstruction is an oncological emergency
most often associated with which cancer
lung (SCLC)
features of SVC obstruction?
dysnpoea most common swelling of face, neck and arms (may have conjunctival and periorbital oedema)
HA often worse in mornings
visual disturbance
pulseless JV elevation
causes of SVC obstruction?
cancer- SCLC, lymphoma
metastatic seminoma, Kaposi's, breast aortic aneurysm mediastinal fibrosis goitre SVC thrombosis
treatment of choice for symptomatic relief in SVC obstruction?
endovascular stenting
T/F: Spinal cord compression is an oncological emergency
true- affects up to 5% of cancer patients
most common mechanism of neoplastic spinal cord compression?
extradural compression in most cases- usually a vertebral body metastasis
more common in lung, breast and prostate cancer
features of spinal cord compression?
back pain (?worse lying down and coughing)
lower limb weakness
sensory loss/ numbness
neuro signs (depend on level)
Neoplastic spinal cord compression
Lesions above L1 usually result in what signs?
Lesions below L1 usually cause what signs?
Tendon reflexes tend to be ____ below the level of the lesion and ___ at the level of the lesion
above L1: UMN signs in legs and a sensory level
below L1: LMN signs in legs and perianal numbness
Tendon reflexes tend to be increased below the level of the lesion and absent at the level of the lesion
Investigation of choice for suspected neoplastic spinal cord compression?
urgent whole spine MRI (24hr)
Management of neoplastic spinal cord compression?
high dose oral dex
urgent oncology assessment for radiotherapy or surgery
If neoplastic spinal cord compression is suspected, high-dose oral dexamethasone should be given before spinal imaging results are available
true - give asap whilst awaiting investigations
