Life-threatening complications in the gynecologic cancer patient

Abstract

THE SUDDEN OCCURRENCE of a life-threatening emergency in the gynecologic patient with potentially curable cancer presents an extraordinary challenge to her physician. Immediate and accurate diagnosis must precede prompt management in order to ensure a satisfactory outcome. The customary margin for error in the gynecologic patient may be rapidly dissipated by advanced disease, dysfunction of multiple organ systems or the adverse sequelae of prior surgery, radiotherapy or chemotherapy. Lifethreatening complications may appear as the first symptom of cancer, as with torsion and infarction of an ovarian tumor in a child. During the course of treatment such complications may be the direct result of intengive therapy, particularly with combined modality therapy. Months or years after successful control of cancer, major complications may arise as a late consequence of therapy or as a harbinger of recurrent disease.