Metastase van een onbekende primaire tumor; beleid afstemmen op histopathologie

- Metastases from an unknown primary tumour are found as the first expression of a disease process in about 5-10 of all cancer patients.

- This situation triggers two subsequent questions: what kind of tumour is it and where does it come from? In the management of these patients close cooperation between the clinician and pathologist is essential.

- Overdiagnosis and overtreatment should be avoided in these patients, 85 of whom will not survive one year.

- By combining morphological examination of cell or tissue preparations with immunohistochemistry the pathologist is able to provide reliable information on the type and sometimes the origin of the tumour, as a result of which those malignancies worth treating can be identified.

- Applying pathological investigation at an early stage may reduce the need for diagnostic imaging and endoscopic investigations.