Evaluation of the patient with carcinoma of unknown origin metastatic to bone

Clin Orthop Relat Res. 2003 Oct:(415 Suppl):S105-9. doi: 10.1097/01.blo.0000093049.96273.e3.

Abstract

Metastatic carcinoma to bone of uncertain primary origin is a common clinical diagnostic scenario. I present a simple and effective staging system to identify primary malignancies. The role of clinical history, physical examination, laboratory studies, and limited radiographic studies are critical to the success of this diagnostic strategy. Needle or open biopsy frequently is needed yet usually is more effective as a confirmatory study for carcinoma or to rule out primary bone sarcomas. Patients who present with a displaced pathologic fracture require an urgent diagnostic and treatment plan that does not compromise future treatment options and provides durable skeletal reconstruction.

Publication types

  • Review

MeSH terms

  • Bone Neoplasms / diagnosis*
  • Bone Neoplasms / secondary*
  • Breast Neoplasms / pathology
  • Humans
  • Male
  • Neoplasm Staging
  • Neoplasms, Unknown Primary / diagnosis*
  • Neoplasms, Unknown Primary / diagnostic imaging
  • Neoplasms, Unknown Primary / pathology
  • Physical Examination
  • Prostatic Neoplasms / pathology
  • Radiography
  • Thyroid Neoplasms / pathology