Endocrine Surgical Emergencies in the Cancer Patient

Abstract

There are few endocrine surgical emergencies in the cancer patient above that seen in the non-cancer population. Endocrine emergencies can be quite common in the cancer patient but are usually nonsurgical. Endocrine surgical emergencies are relatively uncommon in the general population as well. Nevertheless, there are three endocrine surgical emergencies that need to be recognized and treated appropriately in the cancer patient. These are (1) primary hyperparathyroidism as the exacerbating factor or cause of hypercalcemia in malignancy, (2) pheochromocytoma in the setting of other malignancy due to hereditary syndrome, and (3) severe Cushing syndrome in the setting of paraneoplastic ACTH secretion from an unknown or unresectable primary. These can all present as an emergency in the cancer patient, and can be lethal if unrecognized and untreated. While initial treatment is medical to stabilize the patient, surgery should then be performed usually sooner rather than later to definitively resolve the endocrine emergency in the cancer patient.