Surgical Management of Solid Tumors With Hematologic Manifestations: A Mechanism-Based Clinical Review

Solid tumors can be associated with a variety of hematologic manifestations, including paraneoplastic syndromes, coagulopathy, and electrolyte derangements. Evaluation and management require a multidisciplinary approach and a clear understanding of the role and timing of surgical resection, as this can provide definitive treatment. This review summarizes current literature and offers a practical approach to stabilization and surgical-focused management of solid tumors presenting with hematologic manifestations. The scope focuses on hematologic or metabolic paraneoplastic presentations with direct relevance to surgical timing and perioperative care; endocrine hormone excess syndromes (e.g., ectopic ACTH, SIADH) are excluded. For mechanism-linked hematologic or metabolic manifestations, early surgical consultation is recommended. Bridge therapies enable safe anesthesia and resection, while durable correction generally requires tumor control. A standardized, age-focused perioperative approach is integral for optimal patient outcomes.