Metastatic tumours

It is very helpful for the practitioner to have a working knowledge of possible primary sources of tumour when metastatic lesions are detected in various organs.

Common sites of metastatic presentation are the lymph nodes, liver, lung, mediastinum and bone. Other sites include the brain, bone marrow, peritoneum, retroperitoneum, skin and the spinal cord. These important sites (listed below) are followed by likely primary sources with the most likely listed first.

• Liver. Colon, pancreas, liver, stomach, breast, lung, melanoma

• Lung and mediastinum. Breast, lung, colon, kidney, testes, cervix/uterus, Hodgkin's disease, melanoma

• Bone. Breast, prostate, lung, Hodgkin's disease, kidney, thyroid, melanoma

• Brain. Breast, lung, colon, lymphoma, kidney, melanoma, prostate

• Skin. Lung, colon, melanoma, Kaposi's sarcoma

o High cervical. Hodgkin's disease, lymphoma, squamous cell carcinoma, oropharynx, nasopharynx o Low cervical. Lung, stomach, lymphoma, Hodgkin's disease, oropharynx, larynx, skin, tongue o Axillary. Breast, lung, lymphoma o Inguinal. Lymphoma, ovary, uterus, vulva, prostate, skin

• Retroperitoneum. Lymphoma, Hodgkin's disease, ovary, uterus, testes, prostate

It is important to keep in mind those malignancies that are potentially curable and refer as soon as possible.

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