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Extra-thoracic metastases

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Anorexia, weight loss and lethargy frequently indicate disseminated disease. Distant metastasis is most common with small cell carcinoma, followed by adenocarcinoma and large cell carcinoma. It is least common with squamous carcinoma.

Secondary spread may occur to virtually any part of the body. The most common sites are:

  • hilar lymph nodes
  • liver
  • bone
  • brain
  • adrenals

Marrow involvement occurs in 10-20% of cases of advanced small cell carcinoma and may produce a leuco-erythroblastic anaemia. However, anaemia in lung cancer is usually due to due to non-specific effects of malignancy.

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