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Tumor Compression Syndromes, Emergency Medicine

Hany Y. Atallah Reviewed 06/2017



  • Complications arising from the compression of neural or vascular structures by solid tumors or their direct infiltration of such structures

  • Spinal cord compression:

    • Affects over 20,000...


Signs and Symptoms


  • Spinal cord compression:

    • History of malignancy

    • Back or neck pain:

      • Prolonged

      • Worse with rest

      • Most commonly affects the thoracic spine

    • Paresthesias

    • Difficulty ambulating

    • Const...


Initial Stabilization/Therapy

  • Early diagnosis and treatment are the keys to an improved outcome.

  • Level of neurologic dysfunction on presentation is a key factor in the prognosis for spinal cor...



Admission Criteria

  • Admission is advisable for all patients presenting with a tumor compression syndrome.

  • Transfer to a center with neurosurgical capabilities may be needed for patie...

Pearls and Pitfalls

  • Average life expectancy among patients who present with malignancy-associated SVC syndrome is ∼6 mo.

  • Presentations may be subtle and compression syndromes should always be considere...

Additional Reading

  • Cole  JS, Patchell  RA. Metastatic epidural spinal cord compression. Lancet Neurol.  2008;7(5):459–466.

  • Graham  PH, Capp  A, Delaney  G, et al. A pilot randomized comparison of ...



  • 239.9 Neoplasm of unspecified nature, site unspecified

  • 336.9 Unspecified disease of spinal cord

  • 459.2 Compression of vein


  • D49.9 Neoplasm of unspecified behavior of unspecified site

  • G95.29 O...

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