Summary
Definition
History and exam
Other diagnostic factors
- jaundice
- ascites
- personal hx of previous cancer
- hx of smoking
- pain
- palpable mass
- symptoms of post-obstructive pneumonia
- neurological pain or weakness
- headaches
- seizures
- cervical chain adenopathy
- constitutional symptoms
- depression
- delirium
- hx of heavy alcohol consumption
- hepatomegaly
- haemoptysis
Diagnostic investigations
1st investigations to order
- CXR
- CT (chest, abdomen, pelvis)
- mammography
- MRI of breast
- transvaginal ultrasound
- diagnostic paracentesis
- upper aerodigestive panendoscopy (for patients with isolated cervical adenopathy)
Investigations to consider
- colonoscopy (for patients with resectable liver metastases)
- light microscopy, with haematoxylin and eosin (H&E) staining
- immunohistochemical (IHC) markers
- oestrogen and progesterone receptor status
- serum tumour markers
Treatment algorithm
Contributors
Authors
Ross C. Donehower, MD, FACP
Director
Division of Medical Oncology
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
RCD declares that he has no competing interests.
Acknowledgements
Dr Ross C. Donehower would like to gratefully acknowledge Dr David Cosgrove and Dr Hatim Hussain, previous contributors to this monograph. DC and HH declare that they have no competing interests.
Peer reviewers
Nikhil Khushalani, MD
Assistant Professor
Department of Medicine
Roswell Park Cancer Institute
Buffalo
NY
Disclosures
NK declares that he has no competing interests.
Zelig Tochner, MD
Associate Professor
Radiation Oncology
Children's Hospital of Philadelphia
Philadelphia
PA
Disclosures
ZT declares that he has no competing interests.
Justin Stebbing, MA, MRCP, MRCPath, PhD
Consultant Medical Oncologist/Senior Lecturer
Department of Medical Oncology
Imperial College/Imperial Healthcare NHS Trust
Charing Cross Hospital
London
UK
Disclosures
JS declares that he has no competing interests.
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