Home Blog Illary carcinoma, it is very useful. You must be very selective. The diagnostic accuracy of ca125 alone is not good. However, immunohistochemistry in general is very useful. Question: are you looking for these markers during treatment as an indication of the effectiveness of therapy? Answer: if you are dealing with subsets of cup, you should look for the markers suggested. For example, if you are dealing with a male with midline differentiated tumour, and b-hcg + afp levels are raised, it is useful to measure these markers during treatment. However, this occurs in only 20% of patients so is quite rare. Imaging imaging includes conventional radiology, ultrasonography, mammography, and ct, mri or pet scans. A chest x-ray is used as a prerequisite before any further investigations. Barium studies are completely useless in investigating patients with cup. Ct scans are quite useful, with an accuracy of 40%, and can provide useful guidance for biopsy. Mammography is useful in investigating women with breast cancer, but has very low sensitivity. However, an mri in breast cancer patients can increase accuracy to 60%. Fdg-pet scan can be helpful, especially in patients with occult head and neck cancers or lung cancer. These areas are really sensitive to pet scan in finding the primary site. Endoscopy finally, endoscopy is sometimes useful, but not in all patients. Its use should be guided by specific symptoms or signs. cheap viagra online viagra for sale buy viagra generic viagra sales buy viagra buy viagra in the united states buy generic viagra buy cheap viagra viagra for sale cheap viagra For example, ent panendoscopy should only be requested for a patient with cervical node involvement. Bronchoscopy would be indicated in patients who have a positive chest x-ray or ct scan with a cough. Colonoscopy is useful in patients with relevant symptoms or signs, with the same applying to proctoscopy and colposcopy for patients with inguinal node involvement. Question: how often do you personally use pet scans to diagnose cups? Answer: i do not use it as a routine, and it is not even included in the guidelines to rule out occult head and neck cancer or lung cancer. However, if you have suspicions that your patient might have one of these cancers, you could consider it. It is still not accepted by everybody. If i have a patient with cervical lymph node presentation or some suspicions of lung cancer, i would recommend it. But do not do pet scan in all your patients. Question : do you recommend fundoscopy – looking at the back of the eye – as a tool in the search for cup primary sites? Answer : this technique would only be used frequently in the search for melanoma of unknown primary. Otherwise, i would only carry out this process in the search for a primary if i had a biopsy of metastases in the liver that showed melanoma and i could not find any skin primary. In this case, i would have to look at the retina to search for primary retinal melanoma. How often is a primary tumour diagnosed? Available data suggest that the antemortem frequency of detection of primary site by imaging, endoscopy or immu. About Peterswell Past Present Links Contact


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