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      Thoracic complications and emergencies in oncologic patients

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      Publication date (Electronic):
      Journal: Cancer Imaging
      Publisher: e-Med
      Keywords: Esophageal cancer, lung cancer, complications, thoracic neoplasms

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          Abstract

          Oncology patients often experience urgent or emergent medical complications that are a direct or indirect result of the underlying malignant condition and are first identified or clarified on radiologic imaging studies. The aim of this review is to identify, discuss, and illustrate some of the major thoracic complications in patients with primary intrathoracic or extrathoracic neoplasms; particular focus is placed on issues in which radiologic imaging may have a significant impact on patient management, including superior vena cava (SVC) syndrome, post-obstructive pneumonia, diaphragmatic paralysis, pleural effusions, pericardial disease, tracheo-esophageal fistula, deep venous thrombosis, and pulmonary embolism.

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          Clinical practice. Superior vena cava syndrome with malignant causes.

          Frank Detterbeck, Mandy L. Wilson, Joachim Yahalom (2007)
          Article 0 comments Cited 100 times – based on 0 reviews     Review now
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            Diagnosis and management of malignant pleural effusions.

            John Heffner (2007)
            Malignant pleural effusions (MPEs) complicate the clinical course of patients with a broad array of malignancies, which are most often due to lymphomas or carcinomas of the breast, lung, gastrointestinal tract or ovaries. Patients may present with a MPE as the initial manifestation of a cancer or develop an effusion during the advanced phases of a known malignancy. In either circumstance, the median survival after presentation with a MPE is 4 months. Effusions may result from direct pleural invasion (MPE) or indirect effects (paraneoplastic effusions), such as impairment of fluid efflux from the pleural space by lymphatic obstruction or pleural effects of cancer radiation or drug therapy. Because only 50% of patients with cancer who develop a pleural effusion during their clinical course have a MPE, careful evaluation of the effusion to establish its aetiology is required to direct therapy. Management is palliative with interventions directed towards decreasing the volume of intrapleural fluid and the severity of associated symptoms.
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              Evaluation of pleural disease with 18-fluorodeoxyglucose positron emission tomography imaging.

              Renaud Louis, Thierry Bury, Didier Cataldo … (2004)
              To study the ability of positron emission tomography (PET) using 18-fluorodeoxyglucose (FDG) to distinguish between benign and malignant disease in exudative pleural effusions and pleural thickening. Prospective study of 98 consecutive patients presenting with either pleural thickening or an exudative pleural effusion. Department of pulmonary medicine of a university hospital. FDG-PET was performed on each subject before invasive procedures were used to determine the etiologic diagnosis. FDG-PET data were analyzed by visual interpretation. Sixty-three of 98 patients were found to have malignant pleural disease after histologic analysis. Sixty-one of 63 patients with histologically confirmed malignant disease showed FDG uptake within the area of pleural thickening. Uptake was graded as intense in 51 cases and moderate in 10 cases. Only two patients with malignant pleural disease did not show increased FDG uptake. FDG-PET imaging showed an absence of FDG uptake, and correctly classified 31 of 35 benign lesions. For the remaining four lesions, intense FDG uptake was seen in one case of parapneumonic effusion, while moderate and localized uptake was observed in one parapneumonic, one tuberculous, and one uremic pleurisy. The sensitivity of the method to identify malignancy was 96.8% with a negative predictive value of 93.9%, while its specificity was 88.5% and its positive predictive value was 93.8%. Our results suggest that FDG-PET is an effective tool for differentiating between benign and malignant pleural diseases.
              Article 0 comments Cited 18 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cancer Imaging
                Journal ID (publisher-id): CI
                Journal ID (publisher-id): Cancer Imaging
                Title: Cancer Imaging
                Publisher: e-Med
                ISSN (Print): 1740-5025
                ISSN (Electronic): 1470-7330
                Publication date Collection: 2009
                Publication date (Electronic): 2 October 2009
                Volume: 9
                Issue: Special issue A
                Pages: S75-S82
                Affiliations
                Department of Radiology, University of Michigan Medical Center, Ann Arbor, MI, USA
                Author notes
                Corresponding address: Dr Leslie Quint, Department of Radiology, University of Michigan Medical Center, Box 5030, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0030, USA. Email: lequint@ 123456umich.edu
                Article
                Publisher ID: ci099031
                DOI: 10.1102/1470-7330.2009.9031
                PMC ID: 2797469
                PubMed ID: 19965299
                SO-VID: b9ccbc1b-47d4-4c04-ac89-2af3569772b8
                Copyright © © 2009 International Cancer Imaging Society
                History
                Categories
                Subject: Complications and Emergencies in Oncologic Patients

                Keywords: esophageal cancer,lung cancer,complications,thoracic neoplasms
                Data availability:
                Keywords: esophageal cancer, lung cancer, complications, thoracic neoplasms

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