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Related Experiment Videos

Metastatic carcinoma with an unknown primary.

A Gilman, E Fordham, E Wiley

    Medical and Pediatric Oncology
    |January 1, 1984
    PubMed
    Summary

    A 54-year-old female presented with right upper quadrant pain, weight loss, and localized scalp pain. Elevated liver enzymes were noted, prompting further investigation into her symptoms.

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    Area of Science:

    • Hepatology
    • Oncology
    • Dermatology

    Background:

    • A 54-year-old female presented with a 3-week history of right upper quadrant pain, 12-pound weight loss, and pain in the scalp, hip, and back.
    • Initial physical examination revealed a firm, tender nodule on the occiput, with no other significant findings apart from an enlarged liver span (14 cm).

    Observation:

    • Vital signs were normal upon admission.
    • Abnormal laboratory findings included elevated SGOT (106), SGPT (139), and alkaline phosphatase (190).
    • Imaging studies, including chest X-ray, abdominal flat plate, and mammograms, were unremarkable.

    Findings:

    • The patient exhibited symptoms suggestive of hepatobiliary or systemic disease, including right upper quadrant pain and elevated liver enzymes.
    • A palpable occipital nodule and reported posterior scalp pain warrant further investigation for potential metastatic disease or localized pathology.
    • Unexplained weight loss and multifocal pain (scalp, hip, back) in conjunction with abnormal liver function tests indicate a complex clinical presentation.

    Implications:

    • Further diagnostic workup is crucial to determine the etiology of the elevated liver enzymes, weight loss, and pain.
    • The occipital nodule requires biopsy and evaluation to rule out malignancy.
    • A comprehensive approach integrating hepatology, oncology, and potentially dermatology is necessary for accurate diagnosis and management.

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