Oncologic Emergencies

Oncologic emergencies are potentially life-threatening complications that require timely identification and intervention. Although these events are relatively uncommon, they pose significant risks for morbidity and mortality in children with cancer. This review focuses on five of the most critical oncologic emergencies encountered in pediatric practice: febrile neutropenia, hyperleukocytosis, spinal cord compression, tumor lysis syndrome, and superior mediastinal/superior vena cava syndrome. Each presents with a variable constellation of signs and symptoms that may mimic more benign illnesses, underscoring the importance of maintaining a high index of suspicion. Delays in recognition and treatment can result in rapid clinical deterioration, but with prompt supportive care and disease-directed therapy, outcomes can be significantly improved. This article provides a concise, practical overview of the pathophysiology, diagnostic approach, and initial treatment of each condition, with the goal of equipping general pediatricians and frontline providers with the tools necessary to identify these emergencies early and initiate appropriate care.