Oncological Emergencies Dr. Gary Harding md, frcpc

Oncological Emergencies

• Dr. Gary Harding MD, FRCPC

• Medical Oncology Fellow CancerCare Manitoba

CASE 1…

Mr. SV

• ID: 65 year old male with PMHx of CAD and emphysema

• EC: present to clinic with one week history of increasing SOB

• HPI: 3 month history of weight loss, decreased appetite, a change in his chronic cough, and intermittent hemoptysis

On Physical Examination

• Inspection:

Respiratory Examination

• Stridor

• Dullness to percussion on right lower lung fields

• Increased tactile fremitus to right lower lung fields

• Decreased A/E to right lower lung fields

Chest X-Ray…

Thoracentesis

• Exudate

• Gram stain

• Negative

• AFB stain

• Negative

• Cytology

• non-small cell lung cancer
• Large cell type

Superior Vena Cava Syndrome

Definition

• Obstruction of blood flow in the superior vena cava results in signs and symptoms of SVC syndrome

Etiology

• Caused by either invasion or external compression of the SVC by contiguous pathologic process

• Right lung pathology, lymph nodes, other mediastinal structures, or thrombosis