History and exam
Key diagnostic factors
common
bone pain
May be associated with pathological fracture.
family history of cancer
A detailed family history should assess the possibility of an inherited cancer syndrome.
Other diagnostic factors
common
jaundice
Obstructive jaundice may be present due to pancreatico-biliary lesions.
ascites
May indicate peritoneal adenocarcinoma.
personal history of previous cancer
May indicate the possibility of an inherited cancer syndrome.
history of smoking
Cohort data indicate that current smokers are at an increased risk for cancer of unknown primary site (CUP) compared with never-smokers.[37] Smoking more cigarettes, and longer duration of smoking, was associated with higher CUP risk.
uncommon
pain
May be from peritoneal or pleural irritation.
palpable mass
May be noted on physical examination.
symptoms of post-obstructive pneumonia
For example, cough, wheeze, and dyspnoea.
Occurs with parenchymal lung involvement.
neurological pain or weakness
Suggests possible brain or peripheral nervous system metastases.
headaches
Suggests possible central nervous system involvement, which can be present in several tumour subtypes. It may provide some clues but is not specific for a particular tumour type.
seizures
Suggests possible central nervous system involvement, which can be present in several tumour subtypes. It may provide some clues but is not specific for a particular tumour type.
cervical chain adenopathy
There may be localised swelling if superficial lymph nodes are involved.
constitutional symptoms
Patients often report a non-specific deterioration in their overall health: for example, weakness, fatigue, malaise, anorexia, poor appetite, early satiety, nausea, malaise, and weight loss. Such symptoms tend to be progressive.
depression
Can be a symptom of central nervous system (CNS) involvement, but can also suggest infection or electrolyte derangement or other influences.
CNS involvement can be present in several tumour subtypes. It may provide some clues, but is not specific for a particular tumour type.
delirium
Can be a symptom of central nervous system (CNS) involvement, but can also suggest infection or electrolyte derangement or other influences.
CNS involvement can be present in several tumour subtypes. It may provide some clues, but is not specific for a particular tumour type.
history of heavy alcohol consumption
One cohort study found that cancer of unknown primary site risk increased with higher levels of alcohol intake.[37]
hepatomegaly
May be noted on examination due to liver involvement.
haemoptysis
Occurs with parenchymal lung involvement.
Risk factors
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