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Seventy-two patients presenting with symptomatic brain metastases from undiagnosed primary neoplasms were retrospectively reviewed.Primary malignancies were diagnosed before death in 54 patients and remained unknown in 18 patients.Lung cancer was the most common primary tumor(72%) followed by breast cancer,colon carcinoma and melanoma.On physical examination,51 patients had organ specific symptoms or signs providing guidelines to the diagnostic evaluation.In 24 of the 52 patients with a primary lung tumor,and in our of the 20 patients without,organ specific complaints or findings suggested this tumor type,resulting in a positive predictive value of 85%.Overall,radiography and CT of the chest were very useful in detection of primary lung tumors.This could partly be explained by the high prior probability of detecting such tumors.Other diagnostic procedures should be used on indication only.The prognosis of patients with confirmed primary tumor position did not differ from those with unidentified primary tumor. |
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carcinoma of lung
CAT scan
CAT scan,abnormal
CAT scan,chest
chest x-ray,abnormal
malignancy screen
mammogram
neoplasm,metastatic to brain without obvious primary
neoplasm,metastatic to CNS
neoplasm,metastatic to CNS-origin of
neoplasm,metastatic to CNS-prognosis of
neoplasm,metastatic to CNS-work up for
prognosis
screening
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