Fujibuchi T, Imai H, Kidani T, Miura H. Effective examination methods for identifying the primary origins of metastatic bone tumors of unknown primary origin during the initial visit: A retrospective chart review study.
SAGE Open Med 2022;
10:20503121221097582. [PMID:
35646367 PMCID:
PMC9136433 DOI:
10.1177/20503121221097582]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/12/2022] [Indexed: 12/03/2022] Open
Abstract
Objective:
To provide appropriate treatment for patients, early diagnosis of the primary
origin of skeletal metastases of unknown primary origin is important. This
study aimed to assess the examination strategy effective for identifying the
primary origin of skeletal metastases of unknown primary origin.
Methods:
Sixty-one patients with skeletal metastases of unknown primary origin were
reviewed. The primary origin was examined via physical examination, blood
test including tumor markers, chest radiography, thoracoabdominal computed
tomography scan, positron emission tomography–computed tomography scan,
metastatic lesion biopsy, and other assessments. Examination methods
considered effective for the diagnosis of the primary origin in a specific
type of cancer were investigated.
Results:
The lung was the most common primary origin site, followed by the lymph
nodes, prostate, and breast. Meanwhile, biopsy was the most effective
examination, followed by positron emission tomography–computed tomography
scan and thoracoabdominal computed tomography scan. Blood tests are useful
for detecting hematological malignancies and prostate cancer. Computed
tomography scans can be used to identify cancers in the lung, breast, and
kidney, which are the common primary origins. Forty-one (67.2%) of the 61
patients with skeletal metastases of unknown primary origin were diagnosed
via the first four steps, that is, physical examination, blood test, chest
radiography, and thoracoabdominal computed tomography scan. Finally, two
patients were diagnosed with skeletal metastases of unknown primary
origin.
Conclusion:
The examination steps used in this study, including physical examination,
blood test including tumor markers, chest radiography, thoracoabdominal
computed tomography scan, positron emission tomography–computed tomography
scan, biopsy, and other assessments were effective in determining the
primary origin of skeletal metastases of unknown primary origin during the
initial visit.
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