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Occult Malignancy


Presentation

  • ARF presenting with hyperkalemia, hyperuricemia and hyperphosphatemia should lead to further work up for occult haematological malignancy. We describe two cases of lymphoma presenting with ARF secondary to spontaneous TLS.[ncbi.nlm.nih.gov]
  • A case series of 4 patients with occult parotid malignancies presenting with acute-onset unilateral facial paralysis is reported. Initial imaging on all 4 patients did not demonstrate a parotid mass.[ncbi.nlm.nih.gov]
  • Three cases of occult malignancy presenting as acrometastases are reported.[ncbi.nlm.nih.gov]
  • We report on a patient with underlying malignant disease who presented with lower limb ischaemia that was relieved by axillobifemoral bypass.[ncbi.nlm.nih.gov]
  • Xanthogranulomatous pyelonephritis (XGP) can present with weight loss, anemia, leukemoid reaction, and generalized debility; there may be no signs or symptoms referable to the urinary tract.[ncbi.nlm.nih.gov]
Weight Loss
  • Xanthogranulomatous pyelonephritis (XGP) can present with weight loss, anemia, leukemoid reaction, and generalized debility; there may be no signs or symptoms referable to the urinary tract.[ncbi.nlm.nih.gov]
  • Patients with cancer of unknown primary site demonstrate common characteristics and present with general complaints such as anorexia, weight loss, etc. Multiple sites of involvement are shown in more than 50% of patients with occult primary tumors.[aboutcancer.com]
Fatigue
  • Cella D, Kallich J, McDermott A, Xu X: The longitudinal relationship of hemoglobin, fatigue and quality of life in anemic cancer patients: results from five randomized clinical trials. Ann Oncol 2004;15:979.[karger.com]
  • Adenocarcinoma metastatic to unspecified site Cancer Cancer in childbirth Cancer in pregnancy Cancer metastatic to bone Cancer metastatic to ovary Cancer metastatic to parotid gland Cancer metastatic to vagina Cancer of unknown primary Cancer related fatigue[icd10data.com]
  • […] patients with newly diagnosed cancer are found to have cancer without an identifiable primary site, despite exhaustive tests. [ 1 ] Presentation Most patients present with advanced-stage cancers and therefore usually have symptoms of malaise, weakness, fatigue[patient.info]
  • Patients who present with rapid weight loss, especially in the context of pain and/or increasing fatigue and declining activity, should be considered at risk.[racgp.org.au]
Anemia
  • Xanthogranulomatous pyelonephritis (XGP) can present with weight loss, anemia, leukemoid reaction, and generalized debility; there may be no signs or symptoms referable to the urinary tract.[ncbi.nlm.nih.gov]
Malaise
  • Wales about 4% of patients with newly diagnosed cancer are found to have cancer without an identifiable primary site, despite exhaustive tests. [ 1 ] Presentation Most patients present with advanced-stage cancers and therefore usually have symptoms of malaise[patient.info]
Raynaud Phenomenon
  • ’s phenomenon or cutaneous leukocytoclastic vasculitis over age 50 years.[consultant360.com]
Parotid Mass
  • Initial imaging on all 4 patients did not demonstrate a parotid mass. Diagnostic delays ranged from 7 to 36 months from time of onset of facial paralysis to time of diagnosis of parotid malignancy.[ncbi.nlm.nih.gov]
Hepatomegaly
  • Chest examination revealed scattered crackles over bases and a firm hepatomegaly 4 cm below coastal margin. Investigations revealed normal CBC. The ESR was further elevated to 71 mm in the first hour.[consultant360.com]
Musculoskeletal Pain
  • Bone scans of 491 patients with new or recurrent complaints of musculoskeletal pain and no previously known malignancy were retrospectively reviewed.[ncbi.nlm.nih.gov]
Nipple Discharge
  • This study was a retrospective analysis of patients who underwent minor or major duct surgery for pathological nipple discharge.[ncbi.nlm.nih.gov]
Oscillopsia
  • We report a case of primary position downbeating nystagmus due to an occult breast carcinoma in a 57-year-old woman with progressive oscillopsia and truncal ataxia. Acute nausea and vomiting precipitated hospitalization.[ncbi.nlm.nih.gov]
Downbeat Nystagmus
  • Primary position downbeating nystagmus is an uncommon manifestation of an occult malignancy.[ncbi.nlm.nih.gov]
Truncal Ataxia
  • We report a case of primary position downbeating nystagmus due to an occult breast carcinoma in a 57-year-old woman with progressive oscillopsia and truncal ataxia. Acute nausea and vomiting precipitated hospitalization.[ncbi.nlm.nih.gov]

Workup

  • Workup of the first patient found an apical paravertebral mass in the lung; biopsy revealed recurrent breast carcinoma. In the second case, workup found an axillary mass contiguous with the lower brachial plexus.[ncbi.nlm.nih.gov]
  • Even with a complete workup, however, morcellation of occult uterine malignancy remains a possibility. This risk should be discussed as part of informed consent before morcellation.[ncbi.nlm.nih.gov]
  • A diagnostic screening workup including a clinical history, physical examination, complete blood count, blood sedimentation rate, basic biochemistry panel including hepatic and renal function tests, prostate-specific antigen, a chest X-ray and an abdominopelvic[ncbi.nlm.nih.gov]
  • In 10/22 cases, the suspected diagnosis of malignancy could not be confirmed despite extensive workup including specialist visits (n   5), magnetic resonance imaging (n   4), gastrointestinal tract endoscopy (n   3), endometrial biopsies (n   2), and[ncbi.nlm.nih.gov]
  • Any abnormalities uncovered on this initial workup should be aggressively investigated.[the-hospitalist.org]
Mural Thrombus
  • Initial presentation of a malignant disease as recurrent attacks of lower limb ischaemia due to emboli from a mural thrombus in the descending thoracic aorta is extremely rare. A diagnosis of malignancy may thus easily be overlooked.[ncbi.nlm.nih.gov]

Treatment

  • The pathology, bacteriology, diagnosis, and treatment are reviewed.[ncbi.nlm.nih.gov]
  • Detecting occult neoplasia is inherently not possible, but if this theory bears truth, induced autoimmune disease could become a powerful treatment of malignancy.[ncbi.nlm.nih.gov]
  • In both cases, medical treatment of the tumor was instituted, with consequent improvement of hand and shoulder function.[ncbi.nlm.nih.gov]
  • The definite preventative treatment for these cases is early, risk-reducing, bilateral salpingo-oophorectomy (BSO).[ncbi.nlm.nih.gov]

Prognosis

  • Occult cancer, unknown primary A malignancy of unknown 1º site or origin that is symptomless, which first manifests itself as metastases or secondary–paraneoplastic phenomena, and usually has a poor prognosis; OPMs are problematic as appropriate therapy[medical-dictionary.thefreedictionary.com]
  • […] treatable something is, depends on size, type, pathological features, staging of the cancer.Hope you or loved one do well, as the word "cancer" strikes fear in people, but know that many types of cancer are now very treatable.Positive attitude/faith help prognosis[healthtap.com]
  • Favourable prognosis subtypes with specific clinical and histopathological criteria must be recognised and treated on the basis of the presumed primary site.[racgp.org.au]
  • Prognosis Malignancies of unknown primary origin are by definition metastatic cancers and the prognosis is generally poor.[patient.info]
  • […] diagnosis may cause additional stress for the patient. [7] Prognosis [ edit ] Most people with cancer of unknown primary origin have widely disseminated and incurable disease, although a few can be cured through treatment.[en.wikipedia.org]

Etiology

  • Paraneoplastic syndromes and infection are known causes of autoimmunity, but the etiology of most autoimmune syndromes remains unknown.[ncbi.nlm.nih.gov]
  • Cestari DM, Weine DM, Panageas KS, Segal AZ, DeAngelis LM: Stroke in patients with cancer: incidence and etiology. Neurology 2004;62:2025.[karger.com]
  • Incidence of specific etiology and role of methods for specific etiologic diagnosis of primary acute pericarditis. Am J Cardiol . 1995 ; 75 :378–382. Crossref Medline Google Scholar 8. Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y .[circ.ahajournals.org]
  • Certain clinical, laboratory, and radiological features could help physicians determine stroke etiology early.[journals.plos.org]
  • (anglès) Gurrera RJ «Sympathoadrenal hyperactivity and the etiology of neuroleptic malignant syndrome». Am. J. Psychiatry , vol. 156, 2, 1999, pàg. 169–81. PMID : 9989551 .[ca.wikipedia.org]

Epidemiology

  • Objective/s This review summarises the current knowledge regarding the epidemiology, diagnosis, treatment and care of CUP. Discussion The incidence and mortality rates of CUP are declining in Australia.[racgp.org.au]
  • In this article arrow-down Epidemiology arrow-down Presentation arrow-down Investigations arrow-down Differential diagnosis arrow-down Management arrow-down Prognosis Synonym: cancers of unknown primary site Most patients who have malignancy without an[patient.info]
  • If it is a risk factor for the development of subsequent cancer, this could indicate the need for further research, both epidemiological and biological.[bjgp.org]
  • Int Angiol. 25:101–161. 2006. 3 Heit JA: The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 28:370–372. 2008.[spandidos-publications.com]
  • The epidemiology of venous thromboembolism. Circulation 2003 ;107: Suppl 1 : I4 - I8 3. Anderson FA Jr, Wheeler HB, Goldberg RJ, et al.[nejm.org]
Sex distribution
Age distribution

Pathophysiology

  • Mechanisms of Clinical Signs is the first consolidated text of its kind; designed to help medical students and junior doctors understand the pathophysiological mechanisms behind clinical signs.[books.google.com]
  • Pericarditis: pathophysiology, diagnosis, and management. Curr Infect Dis Rep . 2011 ; 13 :308–316. doi: 10.1007/s11908-011-0189-5. Crossref Medline Google Scholar 31.[circ.ahajournals.org]
  • Trousseau’s syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. Medicine (Baltimore). 1977;56(1):1-37.[the-hospitalist.org]
  • (anglès) Northoff G «Catatonia and neuroleptic malignant syndrome: psychopathology and pathophysiology». J Neural Transm , vol. 109, 12, 2002, pàg. 1453–1467. DOI : 10.1007/s00702-002-0762-z . PMID : 12486486 .[ca.wikipedia.org]
  • Glossopharyngeal neuralgia with syncope secondary to tumor: treatment and pathophysiology. Am J Med 1981 ; 71 : 165 –170 Cicogna R, Bonomi FG, Curnis A, et al.[ajnr.org]

Prevention

  • The definite preventative treatment for these cases is early, risk-reducing, bilateral salpingo-oophorectomy (BSO).[ncbi.nlm.nih.gov]
  • We analyzed data from the Randomized Evaluation of Long Term Anticoagulant Therapy study (conducted between December 2005 and March 2009 in 951 clinical centers in 44 countries worldwide), which compared the abilities of dabigatran vs warfarin to prevent[ncbi.nlm.nih.gov]
  • Cancer can begin anywhere in the body and is usually related to one or more genetic mutations that allow normal cells to become malignant by interfering with internal cellular control mechanisms, such as programmed cell death or by preventing ...Read[healthtap.com]
  • Causes, Risk Factors, and Prevention Learn about the possible risk factors for cancer of unknown primary.[cancer.org]
  • The filter is filled with stranded tumor cells, which prevents the hemorrhagic metastasis of malignant cells.[spandidos-publications.com]

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