Identifying the primary site in metastatic cancer of unknown origin. Inadequacy of roentgenographic procedures.
Two hundred sixty-six patients with metastatic nonsquamous carcinoma of unknown origin underwent upper and lower gastrointestinal series, intravenous pyelograms, and chest roentgenograms (CR) for location of a primary cancer site. Of 129 identified cancer sites, only 22 were verified antemortem, whereas necropsy disclosed 25 cases with false-positive examination results. The CR patterns thought typical for lung cancer (eg, single mass lesion and hilar or mediastinal adenopathy) were often shown (43%) to represent metastatic lesions. Because contrast roentgenographic studies are costly, uncomfortable, of low yield, and often misleading, they should be limited to cases with specific organ dysfunction.
D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D002277:Carcinoma / Q000000981:diagnostic imaging; D004064:Digestive System / Q000000981:diagnostic imaging; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D014567:Urography