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actinomycin adenocarcinoma Amer antigens biopsy blood bone metastases brain metastases branchial cleft branchiogenic breast cancer capillary cell carcinoma cent cervical chemotherapy choriocarcinoma circulating cancer cells Clin clinical colon cortisone diagnosis disease dissemination emboli experimental factors favorable Figure fracture gland growth head and neck hepatectomy hepatic artery infusion hepatic metastases histology hypernephroma immunologic incidence irradiation kidney literature liver metastases liver scan Lnng lobectomy lung cancer malignant melanoma meta metastatic cancer metastatic carcinoma metastatic lesion methotrexate mo 0 mo months multiple neck dissection neck nodes neoplasms neuroblastoma nodule noted occur pathologic perfusion precocious and synchronous Precocious Metastases present primary lesion primary tumor problem pulmonary metastases radiation therapy radical neck dissection radiographs radiotherapy Reproduced by permission resection sarcoma secondary solitary metastases spread squamous cell squamous cell carcinoma studies Surg surgery surgical survival survivors symptoms synchronous metastases technique thyroid tion tissue treated treatment tumor cells tumor dose vascular Wilms