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Evaluation and management require a multidisciplinary approach and a clear understanding of the role and timing of surgical resection, as this can provide definitive treatment. This review summarizes current literature and offers a practical approach to stabilization and surgical\u2010focused management of solid tumors presenting with hematologic manifestations. The scope focuses on hematologic or metabolic paraneoplastic presentations with direct relevance to surgical timing and perioperative care; endocrine hormone excess syndromes (e.g., ectopic ACTH, SIADH) are excluded. For mechanism\u2010linked hematologic or metabolic manifestations, early surgical consultation is recommended. Bridge therapies enable safe anesthesia and resection, while durable correction generally requires tumor control. A standardized, age\u2010focused perioperative approach is integral for optimal patient outcomes.<\/jats:p>","DOI":"10.1111\/ejh.70083","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:36:12Z","timestamp":1766363772000},"page":"514-521","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Management of Solid Tumors With Hematologic Manifestations: A Mechanism\u2010Based Clinical Review"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8237-7796","authenticated-orcid":false,"given":"Ghadeer N.","family":"Shnawa","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery Massachusetts General Brigham  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6146-8710","authenticated-orcid":false,"given":"Danielle B.","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery Massachusetts General Brigham  Boston Massachusetts USA"},{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0099"},{"key":"e_1_2_13_3_1","volume-title":"StatPearls","author":"Thapa B.","year":"2023"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2019-206340"},{"key":"e_1_2_13_5_1","volume-title":"Endotext","author":"Tsoli M.","year":"2020"},{"issue":"4","key":"e_1_2_13_6_1","first-page":"163","article-title":"Paraneoplastic Syndromes in Urologic Malignancy: The Many Faces of Renal Cell Carcinoma","volume":"4","author":"Palapattu G. 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