Summary
We have reviewed 29 patients whose first sign of a tumour was a bone metastasis. Two primaries were identified, lung adenocarcinoma and uterine adenocarcinoma and in 2 cases a presumptive diagnosis of tumours of the breast and prostate was made. The mean survival time was 3 months. When bone metastases are found in the absence of a primary tumour, investigation must include a clinical history, physical examination, routine laboratory tests and chest radiographs. Mammography should be done in women, particularly when there are palpable axillary nodes. Abdominal CT scanning and bronchoscopy should only be undertaken when there is a clinical indication.
Résumé
Revue de 29 dossiers de malades chez qui le premier signe de néoplasie était une métastase osseuse. Deux des cancers primitifs ont pu être identifiés: l'un du poumon et l'autre de l'utérus, et dans deux cas on a posé le diagnostic présumé de tumeur du sein et de la prostate. Quand on découvre une métastase osseuse et que le cancer primitif n'est pas connu le bilan doit comporter une anamnèse, un examen clinique, les tests habituels de laboratoire et des radiographies pulmonaires. Une mammographie peut être demandée chez la femme, surtout s'il existe une adénopathie axillaire palpable. On ne pratiquera un examen tomodensitométrique de l'abdomen et une bronchoscopie que si des arguments cliniques les justifient.
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References
Gil M, Vadell X, Fabregat I, Tusquets T, Nogué Aliquer N (1990) Rentabilidad de las pruebas diagnósticas en la neoplasia de origen desconocido. Estudio retrospectivo. Rev Clin Española 186: 252–257
Jordan EW, Shildt MD (1985) Adenocarcinoma of unknown primary site. Cancer 55: 857–860
Kamin PD, Bernardino ME, Wallace (1980) Comparison of ultrasound and computed tomography in the detection of pancreatic malignancy. Cancer 46: 2510–2512
Karsell PR, Sheedy PF, O'Connell MJ (1982) Computed tomography in search of cancer of unknown origin. JAMA 248: 340–343
McMillan JH, Levina E, Stephens RL (1980) Computed body tomography in the evaluation in metastatic adenocarcinoma with an unknown primary site. Radiology 143: 143–146
Nissenblat MJ (1981) The CUP syndrome. Cancer Treat Rev 8: 211–224
Nystrom JS, Weimer JM, Wolf RM, Batemar JR, Viola MV (1979) Identifying the primary site in metastatic cancer of unknown origin. Inadequacy of roengenographic procedures. JAMA 241: 381–383
Romeu J, Texido A, Rosell R (1989) Carcinoma de origen desconocido. Estudio diagnóstico en 48 casos y rentabilidad clinica. Med Clin (Barc) 92: 201–206
Scott Rinenberg Q, Ringenberg Q, Yarbro JW (1986) Presentations and clinical syndromes of tumors of unknown origin. In: Fer MF, Grecco FA, Oldham RK (eds) Poorly differentiated neoplasms and tumors of unknown origin. Grune Stratton, Orlando, 101–120
Simon AM, Bartucci J (1986) The search for the primary tumor in patients with skeletal metastasis of unknown origin. Cancer 58: 1088–1095
Ultmann JE, Phillips TL (1989) Cancer of unknown primary site. Principles and practice of oncology. De Vita, 3rd edn. Lippincott, Philadelphia, pp 1941–1952
Van de Gaast A, Verweij J, Henzen-Logmans SC, Rodenburg CJ, Stoter G (1990) Carcinoma of unknown primary. Identification of a treatable subset. Ann Oncol 1: 119–122
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Barón, M.G., de la Gándara, I., Espinosa, E. et al. Bone metastases as the first manifestation of a tumour. International Orthopaedics 15, 373–376 (1991). https://doi.org/10.1007/BF00186882
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DOI: https://doi.org/10.1007/BF00186882