Turk Onkoloji Dergisi, cilt.24, sa.1, ss.31-35, 2009 (SCI-Expanded)
Cancer patients with unknown primary site may have different presentations. Hematogenous lymph node metastasis probability should be also considered when evaluating patients with right supradiaphragmatic lymph node metastasis. A 68-year-old male with prostatic carcinoma and a 60-year-old male with gastric carcinoma are presented here. The prostate specific antigen (PSA) levels and free/total PSA ratio should be measured in male cancer patients with unknown primary site, as we did in our first patient and immunohistochemical PSA staining in the metastatic lymph node, if necessary. Skin metastasis may occur with lymphatic spread after hematogenous lymph node metastasis, and these lesions might also be used as follow-up criteria for response to the treatment.