Malignant Neoplasm of Unknown Primary Site B052
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/m/malignant-neoplasm-unknown-primary-site-b052-c80
Rulebase for malignant neoplasm of unknown primary site
<h5>Current RMA Instruments</h5><table border="1" cellpadding="1" cellspacing="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2022/0bc545d6f8/103.pdf" target="_blank">Reasonable Hypothesis</a></address></td><td>103 of 2022</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2022/4d2780bb41/104.pdf" target="_blank">Balance of Probabilities</a></address></td><td>104 of 2022</td></tr></tbody></table><h5><b>Changes from previous Instruments</b></h5><p><drupal-media data-entity-type="media" data-entity-uuid="ddf2ba15-af0f-4c1b-8774-df37316c981f" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding</h5><ul><li>ICD-10-AM Code: C80</li></ul><h5>Brief description</h5><p>This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.</p><p><strong>Confirming the diagnosis</strong></p><p>This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women. </p><p>Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient. </p><p>If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.</p><p>The relevant medical specialist will vary with the clinical circumstances.</p><p><b>Conditions excluded from SOP</b></p><ul><li>Hodgkin’s lymphoma*</li><li>Malignant melanoma*</li><li>Metastatic neoplasm where the primary site has been identified - use the relevant SOP</li><li>Non-Hodgkin lymphoma*</li><li>Soft tissue sarcoma*</li></ul><p>* another SOP applies</p><h5>Clinical onset</h5><p>The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.</p><h5><b>Clinical worsening</b></h5><p>The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.</p>
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/rulebase-malignant-neoplasm-unknown-primary-site
A course of therapeutic radiation
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/course-therapeutic-radiation
Alcohol consumption
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/alcohol-consumption
Atomic radiation
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/atomic-radiation
Cigar smoking
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/cigar-smoking
Cigarette smoking
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/cigarette-smoking
No appropriate clinical management for malignant neoplasm of unknown primary
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/no-appropriate-clinical-management-malignant-neoplasm-unknown-primary
Pipe smoking
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/pipe-smoking
Smoking tobacco products - material contribution
Current RMA Instruments
| Reasonable Hypothesis | 103 of 2022 |
| Balance of Probabilities | 104 of 2022 |
Changes from previous Instruments
ICD Coding
- ICD-10-AM Code: C80
Brief description
This diagnosis applies when a metastasis from a malignant neoplasm has been found, but the specific site where the neoplasm first arose cannot be identified. That a tumour is a metastasis and not a primary site will generally be apparent from a mismatch between the location of the tumour and the tissue type (e.g. carcinoma in a lymph node), or the presence of multiple metastases (often at a site where metastases are common e.g. lung, liver, bone), or on other clinical or pathological grounds. Histology will generally show adenocarcinoma, squamous carcinoma, neuroendocrine tumour, or a poorly differentiated tumour.
Confirming the diagnosis
This diagnosis requires the presence of malignancy, where the primary site cannot be determined after a complete history, physical examination and appropriate investigations have been carried out. The extent of appropriate investigation will depend on the patient’s clinical condition and be decided by the treating practitioners. Investigations will generally include a complete blood count, urinalysis, basic serum chemistries, computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis, together with testing for prostate cancer in men and breast cancer in women.
Histopathologic confirmation of the presence of a malignancy and of the tissue type will be routinely required except in cases where it is not possible or not warranted by the condition of the patient.
If a particular primary site is considered probable after appropriate evaluation has been carried out then a diagnosis of malignant neoplasm of unknown primary site would not apply. If the primary site can be narrowed to a region (e.g. head and neck) but not a particular site within that region, then the SOP would apply.
The relevant medical specialist will vary with the clinical circumstances.
Conditions excluded from SOP
- Hodgkin’s lymphoma*
- Malignant melanoma*
- Metastatic neoplasm where the primary site has been identified - use the relevant SOP
- Non-Hodgkin lymphoma*
- Soft tissue sarcoma*
* another SOP applies
Clinical onset
The condition could present in a wide range of ways including with symptoms specific to a metastasis, non-specific symptoms, detection of a lump on examination, or incidental detection on testing performed for another indication.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Generally with this condition effective treatment is difficult, disease progression is likely and the prognosis is poor.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/m/malignant-neoplasm-unknown-primary-site-b052-c80/rulebase-malignant-neoplasm-unknown-primary-site/smoking-tobacco-products-material-contribution