Oncological emergencies (except neutropenic sepsis!) Spinal cord compression


Any other local symptoms e.g. pain, stridor



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Any other local symptoms e.g. pain, stridor.



Superior Vena Cava Obstruction

  • Examination:

    • Extent of problem.
    • Any evidence of malignancy elsewhere
      • Lymphadenopathy.
      • Hepatomegaly.
      • collapse/consolidation of lung.


Superior Vena Cava Obstruction

  • Initial Investigations:

    • CXR – is there a mass?
    • Venogram – is there a clot?
  • If extrinsic compression from mass try and obtain tissue (SCLC, lymphoma treated with chemo)

    • FNA node.
    • Mediastinoscopy.


Superior Vena Cava Obstruction



Superior Vena Cava Obstruction



Treatment options: Clot

    • Local thrombolysis with streptokinase.
    • Anti-coagulation – heparin (IV or LMWH) for at 5/7 whilst starting warfarin.


Treatment Options: Extrinsic compression

  • Steroids:

      • frequently prescribed but no evidence to support their use (Cochrane review)
  • Chemotherapy:

      • used for SCLC, lymphoma and teratoma
      • response rate >70%.
  • Radiotherapy:


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