MedScape Article Unknown Primary and symptoms at the site of metastatic disease

Patients have early dissemination of their cancer without symptoms at the primary site. The symptoms are often at the site of metastases.

•Ascites should lead one to evaluate for a GI or an ovarian primary.

•An axillary mass in a female should make the clinician check for breast cancer.

•A cervical node should lead to a thorough ENT examination.

•A brain metastasis should lead to a search for a lung, breast, or kidney primary.

•Bone metastasis should lead to evaluation for prostate, breast, lung, renal, or thyroid primary.

•A testicular mass should lead to measurement of tumor markers such as beta-human chorionic gonadotropin (beta-HCG) and alpha-fetoprotein (AFP).

http://emedicine.medscape.com/article/280505-overview