Oncologic EmergencyとIVR

Oncologic emergency and interventional procedure in pediatric patient

oncologic emergencyとは主に悪性腫瘍（ときに良性の巨大血管腫など）に関連した原因により，生命の危機が切迫し，救急処置が必要とされるような病態である。oncologic emergencyは神経系，循環器系，呼吸器系など病態は多岐にわたるが，今回は紙面の関係から胸郭内，脊髄，腹腔内病変につき言及する。また，oncologic emergencyには緊急のIVRが行われることもあり，当センターで経験した緊急塞栓術を施行した小児がん患者の1例を提示する。

I here reviewed clinical and radiological findings of oncologic emergency in pediatric patients. Tumors at mediastinum may cause tracheal compression, SVC syndrome, pericardial effusion and respiratory distress. Acute compressive myelopathy due to primary and metastatic vertebral tumor thought to be one of serious oncologic emergency. Massive hemoperitoneum due to abdominal tumor rupture may induce serious hypovolemic status. In such case, emergency interventional angiography and trans-arterial embolization（TAE）may play an important role for maintenance of vital status. Radiologists need to diagnose such oncologic emergency promptly, and discuss with pediatricians, pediatric surgeons, and ER physicians regarding emergency treatment.