Adenocarcinoma of Unknown Origin

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A frequently encountered and challenging clincial problem is that of the patient presenting with evidence of metastatic disease but with no clinically apparent primary site. If biopsy of distant metastasis reveals adenocarcinoma, one must assume that it represents advanced cancer not curable by present methods. Under these circumstances, is a search for the primary tumor no more than a nonproductive academic exercise?

This question was recently addressed by the oncology group at the Ludwig Institute, Sydney, Australia, in a review of records of 87 patients who presented with metastatic adenocarcinoma with the primary site undetected by history, physical examination, and

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