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    hub sciencedirect scopus applications register login login go to scival suite username: password: remember me | not registered? Forgotten your username or password? buy viagra canada Go to athens / institution login remote access activation home publications search my settings my alerts shopping cart help export citation purchase more options... brand viagra canada Email article signed up for journal alerts [remove] alert me about new articles in this journal your selection(s) could not be saved due to an internal error. buy viagra johor Please try again. buy viagra johor Search     all fields     author advanced search     journal/book title     volume   issue   page search tips article outline is loading... Javascript required for article outline cancer treatment reviews volume 8, issue 4, december 1981, pages 211–224 the cup syndrome (carcinoma unknown primary) michael j. Nissenblatt division of hematology-oncology, department of medicine, college of medicine and dentistry of new jersey, rutgers medical school, piscataway, new jersey 08854, u. viagra without a doctor prescription S. A. Available online 16 august 2006 how to cite or link using doi permissions & reprints view full text purchase $31. 50 summary 1. buy viagra johor Ten per cent of adenocarcinomas present without a detectable primary. Cancer unknown primary is a clinical state in which a metastatic deposit is more apparent than its primary. 2. buy real viagra Cancers without a known primary may develop because (a) metastases may occur during a prolonged clinically silent period of a neoplasm, (b) the primary neoplasm may be small or undergo actual regression, or (c) the primary may exhibit an unusual pattern of progression resulting in early dissemination. 3. viagra commonly asked questions Cancers of unknown primary exhibit atypical behavior. (a) cup primaries often originate in organs other than the expected pattern of known primaries and originate below the diaphragm 75% of the time. The most common source is pancreas, followed by cancer of the liver and stomach. (b) twenty-five per cent of cup cancers originate above the diaphragm. The most common sources in this location are cancers of lung and thyroid. Breast cancer is a rare cause of cancer unknown primary. 4. buy cheap viagra Cancers of unknown primary metastasize in a pattern other than that of known primaries from the same organs. buy viagra 5. The philosophy of management of cup cancers should reflect the recognition that tumors that present with metastases are incurable and that a prolonged effort devoted toward diagnosis may detract from the quality of life. generic viagra blog Therefore, a plan of diagnostic efficiency is essential. Careful physical examination, simple bedside and laboratory investigations supplemented selectively with studies of those organs found to be abnormal by these inexpensive screening procedures is appropriate. 6. Effective palliation and, at t. viagra canada