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March 1969

Solitary Metastases.

Arch Intern Med. 1969;123(3):354. doi:10.1001/archinte.1969.00300130136029

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Another excellent monograph from the American Lectures in Radiation Therapy series, this book devotes individual chapters to aspects of solitary metastases (lungs, liver, brain, lymph nodes of the neck, bone, and "solitary metastases to other sites"). It is profusely illustrated with radiographs, scintigrams, and explanatory diagrams. It is a handy information source for the clinician beset by the frequent problem of evaluating the solitary metastasis.

The concluding chapter is a frank discussion of the realities of dealing with the solitary focus. "All too frequently, a solitary metastasis is an illusion rather than a reality. Cancer deaths are usually due to metastases. Evidence to date suggests that a careful clinical and laboratory study will demonstrate associated metastatic disease or multiplicity of lesions in 80% of cases." The authors recommend thorough diagnostic workup with careful evaluation before aggressive treatment is undertaken. Their approach is practical, not pessimistic.

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