title: Evaluation of clinical problems associated with bone metastases from carcinoma from unknown primary sites.
abstract: BACKGROUND
  This study focused on the evaluation of data concerning the clinical features of patients who were initially diagnosed with bone metastases of carcinoma from unknown primary sites that could not be detected, even using state of-the-art diagnostic modalities.
  
  
  METHODS
  The oncologic outcome of these patients is discussed.
  
  
  METHODS
  The clinical records of seven patients who had presented with bone metastases of carcinoma from unknown primary sites were retrospectively reviewed. Clinical features, treatment and outcome were analyzed. Extraskeletal metastases were located in the lymph nodes, liver, skeletal muscle, kidney, adrenal gland, and pleura. Six cases were observed in the pelvis, three in the femur, three in the skull, two in the rib, two in the cervical spine, two in the thoracic spine, two in the lumbar spine, one in the humerus, one in the radius, one in the clavicle, one in the scapula and one in the sternum. Four patients received systemic chemotherapy including platinum.
  
  
  RESULTS
  At the last follow-up time of average 272 days, six patients were dead of disease and one patient was alive with disease. Although considerable progress has been made in the development of diagnostic modalities, including more recently FDG-PET, the primary tumor site cannot always be identified. Multiple bone and visceral organ metastases are often present in patients whose primary tumor was not detected.
  
  
  CONCLUSIONS
  In the present study, it was found that systemic chemotherapy can appreciably increase the survival time of the patients with carcinoma metastases from unknown primary sites.
authors.affiliation: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. hoshi@med.osaka-cu.ac.jp
authors.forename: Manabu
authors.initials: M
authors.lastname: Hoshi
authors.forename: Susumu
authors.initials: S
authors.lastname: Taguchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Hayakawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Ieguchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology / Q000556:secondary; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D012189:Retrospective Studies