ONCOLOGIC EMERGENCIES

This article focuses on the common emergencies that are the first sign of cancer in a previously well child and those occurring from treatme nt or at the time of relapse. Space-occupying lesions include compress ion of the superior vena cava or airway that may lead to respiratory o r circulatory failure, spinal cord compression (which carries the risk of irreversible paraplegia or urinary incontinence), and brain tumors that may present with life-threatening raised intracranial pressure. Hematologic emergencies include bone marrow failure with anemia and th rombocytopenia, hyperleukocytosis with the high risk of thrombotic eve nts, and coagulation abnormalities. Life-threatening metabolic abnorma lities must be considered in children with leukemia and lymphoma at th e time of diagnosis. Prompt recognition and treatment of these emergen cies may save the life of the child with cancer.