From the Guidelines
The most common sites of lung cancer metastasis are the lymph nodes, liver, adrenal glands, bone, brain, and pleura. Lung cancer can metastasize to any organ, but these sites are the most frequently affected due to their rich blood supply and lymphatic drainage 1. The symptoms of metastasis vary depending on the site, with lymph node metastasis often being asymptomatic, while liver metastases may cause weakness and weight loss 1. Adrenal metastases are typically asymptomatic and rarely cause adrenal insufficiency, but must be distinguished from benign adrenal adenomas 1. Bone pain is a common symptom of metastatic lung cancer, affecting 6% to 25% of patients at presentation, with the vertebral bodies being the most common site 1. Brain metastases can cause headache, nausea, vomiting, seizures, or mental status changes, and may be asymptomatic in some cases 1.
Some key points to consider when evaluating patients with suspected lung cancer metastasis include:
- The presence of systemic symptoms such as anorexia, weight loss, or fatigue 1
- The presence of bone pain or bony tenderness 1
- Elevation of serum calcium or alkaline phosphatase 1
- Neurologic symptoms or focal neurologic signs 1
- The need for biopsy of a metastatic site to establish diagnosis and stage 1
Understanding the common sites of lung cancer metastasis is crucial for proper staging, treatment planning, and surveillance in lung cancer patients. By recognizing the symptoms and signs associated with metastasis to these sites, clinicians can provide timely and effective care to improve patient outcomes 1.
From the Research
Common Sites of Lung Cancer Metastasis
The most common sites of lung cancer metastasis include:
- Brain 2, 3
- Bone 2, 4, 3, 5
- Liver 2, 3, 5, 6
- Adrenal glands 2, 3, 5, 6
- Contralateral lung 2
- Distant lymph nodes 2
- Respiratory system 3
- Nervous system 3
Uncommon Sites of Metastasis
Uncommon sites of lung cancer metastasis may include:
- Soft tissue 2
- Kidney 2
- Pancreas 2
- Spleen 2
- Peritoneum 2
- Intestine 2
- Bone marrow 2
- Eye 2
- Ovary 2
- Thyroid 2
- Heart 2
- Breast 2
- Tonsil 2
- Nasal cavity 2
- Pituitary gland 5
- Ureter 6
Prognosis and Survival
The presence of metastasis, particularly to uncommon sites, may indicate a poor prognosis 2, 3, 5. The survival rate varies depending on the site of metastasis, with liver metastases conferring the worst prognosis 3.