Sandbox:Roukoz

Tumor of unknown primary origin

• Full medical history and physical exam • Basic blood and biochemical analysis • CT scan of chest, abdomen, and pelvis

Histopathologic examination

Squamous cell carcinoma

Neuroendocrine carcinoma

Adenocarcinoma and poorly differntiated carcinoma

• Octreoscan • Plasma chromogranin A

Additional tests specific to location of metastasis

Additional tests speciifc to gender

Cervical lymphadenopathy

Inguinal lymphadenopathy

Bone metastasis

Men

Women

• Panendoscopy • CT scan of head and neck • Diagnostic bilateral amygdalectomy

• Complete clinical examination of external genital organs • Pelvic CT scan or ultrasound

• Anoscopy • Colposcopy (if female) • Complete clinical examination of head and neck • Panendoscopy • Bone scintigraphy • Xrays of painful areas

• PSA • αFP • βHCG

• Mammography • Pelvic ultrasound or CT scan

Additional tests specific to location of metastasis

Midline and/or mediastinal lymphadenopathy

Cervical and/or supraclavicular lymphadenopathy

Axillary lymphadenopathy

Liver metastasis

Lung metastasis

Bone metastasis

Single metastasis

Pleural effusion

Periotneal effusion

• Testicular ultrasound • Chest and abdominal CT scan

• Testicular ultrasound • Head and neck CT scan • Panendoscopy • EBV testing (to rule out undifferentiated nasopharyngeal carcinoma)

Women: • Breast ultrasound • Breast MRI

Women: • αFP assay (if undifferntiated carcinoma) • Colposcopy

Women: • βHCG Men: • Testicular ultrasound • Chest and abdominal CT scan

• Bone scintigraphy • Xrays of painful areas

• Full body CT scan • Bone scintigraphy

• Chest CT scan

Women: • Abdominal and pelvic CT scan