ABSTRACT
Some patients are diagnosed as having disseminated cancer but with no evidence of the site of origin, many presenting with their disease as an incidental finding, e.g. enlarged cervical lymph node(s), bone metastases or pulmonary metastases on chest X-ray. Their management is a difficult problem, the oncologist having to determine whether the patient has a curable tumour such as a teratoma or lymphoma, one that can benefit from systemic therapy (e.g. a hormone-responsive cancer such as from the breast or prostate), or one where treatment would not be justified.
