[Metastasis and special explorations in the study of the spread of bronchogenic carcinoma (author's transl)]

The results of a prospective study on bronchogenic carcinoma are analyzed. The most frequent metastatic localization being the bone (24 percent), followed by the brain (21 percent) and the pleura (20 percent). The type which most frequently metastatized to the brain is the epidermoid carcinoma. The as yet unresolved difficulties in the diagnosis of metastasis to the adrenal glands as well as to the liver are pointed out, conducting a comparative study with data from necropsies in order to corroborate such defficiencies. We systematically practiced radioisotope bone scanning, eliminating the bone radiography and carrying it out only in areas with pathologic isotopic uptake. Biopsy of the iliac crest should be performed in all cases of undifferentiated small-cell type, although this is not necessary with the other histopathologic types. Finally, the criteria for the identification of liver metastasis, in the absence of more proper pilot studies, should be the same as those established in 1974; physical examination and determination of hepatic enzymes; if the results are abnormal, a liver scanning should be indicated, and if it is normal, it will be necessary to perform a liver biopsy by peritoneoscopy.