Evaluation of suspected malignancies: Difference between revisions
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==Primary tumor versus metastasis== | ==Primary tumor versus metastasis== | ||
[[File:Metastasis sites for common cancers.svg|thumb|240px|Main sites of metastases for some common cancer types. Primary cancers are denoted by "''...cancer''" and their main metastasis sites are denoted by "''...metastases''".<ref>List of included entries and references is found on main image page in Commons: [https://commons.wikimedia.org/wiki/File:Metastasis_sites_for_common_cancers.svg Wikimedia Commons: Metastasis sites for common cancers.svg]</ref>]] | [[File:Metastasis sites for common cancers.svg|thumb|240px|Main sites of metastases for some common cancer types. Primary cancers are denoted by "''...cancer''" and their main metastasis sites are denoted by "''...metastases''".<ref>List of included entries and references is found on main image page in Commons: [https://commons.wikimedia.org/wiki/File:Metastasis_sites_for_common_cancers.svg Wikimedia Commons: Metastasis sites for common cancers.svg]</ref>]] | ||
If a suspected malignancy is present, generally check the patient '''history''' for any history of cancer, especially for tumors in more common metastasis sites, which mainly include lung, bone, liver and/or brain. If there is no known history of cancer, still consider a metastasis of unknown primary origin, especially for suspected malignancies in lymph nodes, liver, lungs, bones, or skin.<ref>Lymph nodes, liver, lungs, bones, or skin are the main sites of cancer of unknown primary origin (CUP):<br>{{cite web|url=https://www.mskcc.org/cancer-care/types/cancer-unknown-primary-origin|title=Cancer of Unknown Primary Origin|website=Memorial Sloan Kettering Cancer Center|accessdate=20222-10-14</ref> | If a suspected malignancy is present, generally check the patient '''history''' for any history of cancer, especially for tumors in more common metastasis sites, which mainly include lung, bone, liver and/or brain. In case of such history, preferably look at the microscopy slides of the past cancer to help determining whether the current case is of the same origin, versus a primary at the current body location, versus a metastasis of yet another location. If there is no known history of cancer, still consider a metastasis of unknown primary origin, especially for suspected malignancies in lymph nodes, liver, lungs, bones, or skin.<ref>Lymph nodes, liver, lungs, bones, or skin are the main sites of cancer of unknown primary origin (CUP):<br>{{cite web|url=https://www.mskcc.org/cancer-care/types/cancer-unknown-primary-origin|title=Cancer of Unknown Primary Origin|website=Memorial Sloan Kettering Cancer Center|accessdate=20222-10-14</ref> | ||
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|+Metastases of unknown primary origin<ref name="pmid25392080">{{cite journal| author=Collado Martín R, García Palomo A, de la Cruz Merino L, Borrega García P, Barón Duarte FJ, Spanish Society for Medical Oncology| title=Clinical guideline SEOM: cancer of unknown primary site. | journal=Clin Transl Oncol | year= 2014 | volume= 16 | issue= 12 | pages= 1091-7 | pmid=25392080 | doi=10.1007/s12094-014-1244-0 | pmc=4239766 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25392080 }} </ref> | |+Metastases of unknown primary origin<ref name="pmid25392080">{{cite journal| author=Collado Martín R, García Palomo A, de la Cruz Merino L, Borrega García P, Barón Duarte FJ, Spanish Society for Medical Oncology| title=Clinical guideline SEOM: cancer of unknown primary site. | journal=Clin Transl Oncol | year= 2014 | volume= 16 | issue= 12 | pages= 1091-7 | pmid=25392080 | doi=10.1007/s12094-014-1244-0 | pmc=4239766 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25392080 }} </ref> | ||
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===Undifferentiated tumor=== | ===Undifferentiated tumor=== | ||
An initial panel of cytokeratin (CK), S100, vimentin and LCA (CD45) can be used.<ref name="pmid25427040">{{cite journal| author=Lin F, Liu H| title=Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. | journal=Arch Pathol Lab Med | year= 2014 | volume= 138 | issue= 12 | pages= 1583-610 | pmid=25427040 | doi=10.5858/arpa.2014-0061-RA | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25427040 }} </ref> | An initial panel of cytokeratin (CK), S100, vimentin and LCA (CD45) can be used (see source article for subsequent work-up).<ref name="pmid25427040">{{cite journal| author=Lin F, Liu H| title=Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. | journal=Arch Pathol Lab Med | year= 2014 | volume= 138 | issue= 12 | pages= 1583-610 | pmid=25427040 | doi=10.5858/arpa.2014-0061-RA | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25427040 }} </ref> | ||
===Non-neoplastic=== | ===Non-neoplastic=== | ||