Most common site of metastasis from bronchogenic carcinoma:

Ans: b (Liver) Ref: Robbins, 7th ed, p. 760Among the options given liver is the most common site of metastasis from bronchogenic carcinoma. But according to Robbins more than half of the cases of lung carcinoma spread to adrenal, and adrenals are the most common site of metastasis from lung carcinoma. So if both liver and adrenals are given in the option, choose adrenals.Order of metastasisAdrenals: > 50%Liver: 30-50%Brain: 20%Bone: 20%Important points of the various types of bronchogenic carcinomaAdenocarcinomaMost common histological type worldwideMost common histological type in life time non- smokersMost common histological type in young patientsMost common Ca lung which metastizes to opposite lungPeripheral in distributionMost common variety associated with thrombophlebitisSquamous cell CaMost common histological type in IndiaCavities are seenCentral in distributionPancoast tumor is squamous cell variety. It is located in the apex (not in the centre)Most common variety associated with hypercalcaemiaIt has best prognosisSmall cell CaMost common variety associated with paraneoplastic syndromesMost common variety associated with hypokalemiaMost responsive to chemotherapy and radiation. But due to late detection it has the worst prognosisNoteMost common variety associated with gynaecomastia - large cell carcinoma