Tumor Compression Syndromes
To view the entire topic, please log in or purchase a subscription.
Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
Description
- Complications arising from the compression of neural or vascular structures by solid tumors or their direct infiltration of such structures
- Spinal cord compression:
- Affects >20,000 patients each year
- Occurs in 5–14% of cancer patients
- More than 90% of cases are metastases from lung, breast, prostate cancer, multiple myeloma, Hodgkins, and non-Hodgkins lymphoma
- In children sarcomas and neuroblastomas are the most frequent causes
- 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
Etiology
- 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):
- Non–small-cell lung cancer primarily (50%)
- Small-cell lung cancer (25%)
- Non-Hodgkins lymphoma (10%)
- Incidence due to thrombosis rising due to use of intravascular devices such as catheters and pacemakers
- Postirradiation fibrosis
- Lymphoma
- Breast cancer
- Testicular cancer
- See Differential Diagnosis for nonmalignant etiologies of the SVC syndrome
- Lung cancer (most common):
Pediatric Considerations
In children with spinal cord compression, common causes are sarcoma, neuroblastoma, germ cell tumors, and lymphoma
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Complications arising from the compression of neural or vascular structures by solid tumors or their direct infiltration of such structures
- Spinal cord compression:
- Affects >20,000 patients each year
- Occurs in 5–14% of cancer patients
- More than 90% of cases are metastases from lung, breast, prostate cancer, multiple myeloma, Hodgkins, and non-Hodgkins lymphoma
- In children sarcomas and neuroblastomas are the most frequent causes
- 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
Etiology
- 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):
- Non–small-cell lung cancer primarily (50%)
- Small-cell lung cancer (25%)
- Non-Hodgkins lymphoma (10%)
- Incidence due to thrombosis rising due to use of intravascular devices such as catheters and pacemakers
- Postirradiation fibrosis
- Lymphoma
- Breast cancer
- Testicular cancer
- See Differential Diagnosis for nonmalignant etiologies of the SVC syndrome
- Lung cancer (most common):
Pediatric Considerations
In children with spinal cord compression, common causes are sarcoma, neuroblastoma, germ cell tumors, and lymphoma
There's more to see -- the rest of this topic is available only to subscribers.