The Location of Metastases from the Urinary Tract, The Prostate, and the Thyroid Gland


Before determining the type of treatment of definitely malignant conditions of the thyroid gland, the urinary tract, and the prostate, it is very important to determine the presence or absence of metastases from these malignancies. The finding of metastatic lesions by roentgenographic examination may confirm the presence of a primary malignancy in one of these organs.

In order to ascertain what organ harbors the primary lesion, it is necessary to know some of the characteristics of the areas of metastasis. Metastasis may take place by the lymphatic route. This is particularly true in the case of carcinoma, except of the adeno-carcinoma type.

Metastases by the lymphatic route, however, can not well be determined by roentgenographic examination because enlarged metastatic lymph nodes can seldom be recognized by this method. We have chosen for discussion, therefore, those tumors which are more frequently disseminated by way of the blood stream on account of the more or less encapsulated character of the masses. In their metastatic growth these tumors appear as rather distinct, nodular, or well-defined masses which are quite similar in appearance. They are easily recognized in the chest as dense tumor masses (Figs. 1, 2, 3, 4, 5 and 6) and in the osseous system as rounded areas of destruction in the bones without any evidence of bone production (Figs. 7 and 8). (Fig. 11). The area in which these tumors grow, completely destroying the bone, is sometimes designated by the roentgenologist as a “punched out area.” These punched out areas are. . .