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Tumor Compression Syndromes

Tumor Compression Syndromes is a topic covered in the 5-Minute Emergency Consult.

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  • Complications arising from the compression of neural or vascular structures by solid tumors or their direct infiltration of such structures
  • Spinal cord compression:
    • Affects over 20,000 patients each year
    • Occurs in 5–14% of cancer patients
    • More than 50% of cases are metastases from lung, breast, or prostate cancer.
    • Vertebral metastases are far more common than epidural spinal cord compression (ESCC).
    • Approximately 20% of cases of ESCC represent the initial manifestation of malignancy.
  • Other neurologic tumor compression:
    • Brachial plexus
    • Recurrent laryngeal nerve compression by mediastinal lymph nodes
  • Superior vena cava (SVC) syndrome:
    • Obstruction of returning blood flow in the SVC by compression, infiltration, or thrombosis
    • Venous hypertension within the area ordinarily drained by the SVC
    • In severe cases, gradual elevation of the intracranial pressure (ICP), with altered mental status and coma
    • 60–85% caused by malignancy


  • Spinal cord compression:
    • Prostate cancer
    • Breast cancer
    • Lung cancer
    • Renal cell carcinoma
    • Multiple myeloma
    • Melanoma
    • Thyroid cancer
    • Lymphoma
    • Sarcoma
  • Brachial plexus compression:
    • 0.4% of cancers
    • 2–5% of those who receive radiation treatment
    • Lung cancer
    • Breast cancer
  • SVC syndrome from tumor compression:
    • Lung cancer (most common):
      • Small cell lung cancer primarily
  • Postirradiation fibrosis
  • Lymphoma
  • Breast cancer
  • Testicular cancer
  • See “Differential Diagnosis” for non malignant etiologies of the SVC syndrome.

Pediatric Considerations
In children with spinal cord compression, common causes are sarcoma, neuroblastoma, germ cell tumors, and lymphoma.

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Rosen, Peter, et al., editors. "Tumor Compression Syndromes." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307268/all/Tumor_Compression_Syndromes.
Tumor Compression Syndromes. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307268/all/Tumor_Compression_Syndromes. Accessed April 24, 2019.
Tumor Compression Syndromes. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307268/all/Tumor_Compression_Syndromes
Tumor Compression Syndromes [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307268/all/Tumor_Compression_Syndromes.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Tumor Compression Syndromes ID - 307268 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307268/all/Tumor_Compression_Syndromes PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -