[Diagnostic management of inaugurable metastases].
A COMPLEX SITUATION: Carcinomas of unknown primary site (CUP) represent at least 3% of cancers in adults. This group is heterogenic and difficult to treat, the central element of which is permanent discussions between the physician and the anatomopathologist. SPECIFIC CLINICAL FORMS: The physician must rapidly identify certain entities of good prognosis or particular treatment: cervical lymph node metastases, axillary adenopathies from occult breast cancer, primary papillary peritoneal carcinomatosis, and median line syndrome. OTHER THAN IN THESE SITUATIONS: Present recommended diagnosis strategy is limited and non-invasive (histological review with immunohistochemistry, measurement of alphaFP, beta-HCG, PSA, chest X ray, mammography, tomography of abdomen and pelvis). Positron emission scintigraphy would merit further evaluation.
Penel
Nicolas
N
Département de cancérologie générale, Centre Oscar Lambret 3, rue F. Combemale, 59020 Lille Cedex. n-penel@o-lambret.fr
D014408:Biomarkers, Tumor / Q000378:metabolism; D018394:CA-125 Antigen / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism / Q000556:secondary*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D017430:Prostate-Specific Antigen / Q000276:immunology / Q000378:metabolism; D009418:S100 Proteins / Q000378:metabolism; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D018997:Chorionic Gonadotropin, beta Subunit, Human; D018396:Mucin-1; D009418:S100 Proteins; D000509:alpha-Fetoproteins; D007633:Keratins; D017430:Prostate-Specific Antigen