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Poorly differentiated neoplasms
R/O lymphoma, melanoma, sarcoma,...
34-66% of poorly differentiated neoplasms were found to be lymphomas after further path studies.
Poorly differentiated carcinomas account for the remaining tumors in this group.
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Adenocarcinoma of unknown primary site
Accounts for 70% of unknown primary cases
WOMEN WITH PERITNOEAL CARCINOMATOSIS: Treat as stage III ovarian CA ie Carbo+Taxol
Long term remission in 15-20% of patients.
WOMEN WITH AXILLARY NODE METASTASIS: Check for ER/PR receptors. If met isolated to the axillary node, it should be treated as stage II breast cancer with potential for cure. When mastectomy is performed, an occult breast ca is identified in 44-82% of patients.
MEN WITH SKELETAL METASTASIS: Suspect metastatic prostate ca. especially if skeletal met is the dominant site and the cells are blastic. Stain it for PSA. Obtain PSA levels. Also suspect kidney, thyroid, colon, and bronchus.
SINGLE METASTIC LESION: Resect if technically feasable. If poorly differentiated carcinoma, then consider platinum. Also consider XRT to the region.
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Squamous Carcinoma of Unknown Primary
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