Identifying the primary site in metastatic cancer of unknown origin. Inadequacy of roentgenographic procedures

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Abstract
Patients (266) with metastatic nonsquamous carcinoma of unknown origin underwent upper and lower gastrointestinal series, i.v. pyelograms and chest roentgenograms (CR) for location of a primary cancer site. Of 129 identified primary cancer sites only 22 were verified antemortem, whereas necropsy disclosed 25 cases with false-positive examination results. The CR patterns though typical for lung cancer (e.g., single mass lesion and hilar or mediastinal adenopathy) often (43%) represented metastatic lesions. Because contrast roentgenographic studies are costly, uncomfortable, of low yield and often misleading, they should be limited to cases with specific organ dysfunction.

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