Investigation of special clinical presentations

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Oncology

Metastatic of unknown primary origin

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Investigation of specific clinical presentations

Intrapulmonary nodules without evidence of endobronchial disease

offer flexible bronchoscopy with biopsy, brushings and washings to patients presenting with intrapulmonary nodules of probable metastatic origin that are unsuitable for percutaneous biopsy, even in the absence of endobronchial or central nodal disease on imaging

offer video-assisted thoracoscopic surgery (VATS) exploration to patients only after a negative bronchoscopic procedure and where percutaneous biopsy is considered inappropriate

Investigation of malignant peritoneal disease

obtain a tissue sample for histological examination in patients with MUO who present with ascites, if technically possible

1) NICE (July 2010). Metastatic malignant disease of unknown primary origin - Diagnosis and management of metastatic malignant disease of unknown primary origin

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Investigation of special clinical presentations

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