Metastatic disease manifestations
Framing
- Metastatic disease can present as an oncological emergency through several distinct mechanisms - mass effect (cerebral metastases, spinal cord compression), fluid accumulation (malignant pleural effusion/ascites, cardiac tamponade), vascular obstruction (SVC obstruction), or metabolic derangement (hypercalcaemia) - each requiring urgent, mechanism-specific intervention rather than routine oncology follow-up
- Recognising these presentations as emergencies (not incidental findings to address electively) is essential, since delay can cause irreversible harm (paraplegia from missed cord compression, cardiac arrest from untreated tamponade)
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