Abstract
The management of metastases of unknown primary origin presents considerable challenges to the treating physician, because therapy decisions are often determined by the nature of the primary tumor. Metastases originating from an unknown source are known as “CUP tumors” (carcinoma of unknown primary). Incidence of CUP tumors ranges from 0.5 to 10% of all newly diagnosed tumors [2, 8, 11, 15, 19, 26]; they are more prevalent in males and the mean age of diagnosis is about 60 years. Frequent first sittings for the metastatic lesions are lymph nodes (37%); of these, 31% are located in the head and neck region, which is the most common site for metastases of unknown origin [14].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Aassar OS, Fischbein NJ, Caputo GR, Kaplan MJ, Price DC, Singer MI, Dillon WP, Hawkins RA (1999) Radiology 210:177–181
Abbruzzese JL, Abbruzzese MC, Hess KR, Raber MN, Lenzi R, Frost P (1994) Unknown primary carcinoma: natural history and prognostic factors in 657 consecutive patients. J Clin Oncol 12:1272–1280
Altmann E, Cadmann E (1986) An analysis of 1539 patients with cancer of unknown primary site. Cancer 57:120–124
Bailet JW, Abemayor E, tabour BA, Hawkins RA (1992) HoC; Ward PH:Positron emission tomography: a new, precise imaging modality for detection of primary head and neck tumors and assessment of cervical adenopathy. Laryngoscope 102:281–288
Brewin T (1981) The cancer patient - too many scans and X-rays? Lancet 1:1098–1099
DiChiro G, Brooks RA (1988) PET quantitation: blessing and curse. J Nucl Med 29:1603–1604
Frost P (1991) Unknown primary tumors: an example of accelerated (type 2) tumor progression. In: Sudilovski O (Ed) Boundaries between Promotion and Progression during carcinogenesis. New York: Plenum Press, pp 233–241
Gitten R, Horton MB (1990) Issues in the management of patients with carcinoma of unknown primary site. Curr Concepts Oncol 9:7–15
Hainsworth JD, Wright EP, Johnson DH, Davis BW, Greco FA (1991) Poorly differentiated carcinoma of unknown primary site: clinical usefulness of immunoperoxidase staining. J Clin Oncol 9:1931–1938
Keyes JW (1995) SUV: standard uptake or silly useless value? J Nucl Med 36:1836–1839
Kirsten F, Chi CH, Leeary JA, Ng AB, Hedley DW, Tattersall MH (1987) Metastatic adeno-or undifferentiated carcinoma from an unknown primary site - Natural history and guidelines for identification of treatable subsets. Q J Med 62:143–161
Kole A, Nieweg O, Pruim J, et al (1998) Detection of unknown occult primary tumors using positron emission tomography. Cancer 82:1160–1166
Kruger R, de Leon F, Maihoff J (1992) Der Wert der Immunhistochemie in der histologischen Routinediagnostik von Metastasen unbekannter Primartumoren Pathologe 13:65–72
Lefebvre JL, Coche-Dequeant B, Ton Van J, Buisset E, Adenis A (1990) Cervical lymph nodes from an unknown primary tumor in 190 patients. Am J Surg 160:443–446
Leonard RJ, Nystrom JS (1993) Diagnostic evaluation of patients with carcinoma of unknwown primary tumor site. Sem Oncol 20(3)244–250
Lote K (1989) Metastatic cancer from unknown primary site. In: Veronesi U, Arnesjo B, Burn I, Denis L, Mazzeo F (ed) Surgical Oncology. A European Handbook. Springer, Berlin Heidelberg New York, pp 976–983
Mohit-Tabatabai MA, Dasmahapatra KS, Rush BF, Ohanian M (1986) Management of squamous cell carcinoma of unknown origin in cervical lymph nodes. Am J Surg 52:152–154
Mukherji S, Drane W, Mancuso A, Parsons J, Mendenhall W, Stringer S (1996) Occult primary tumors of the head and neck: detection with 2-(F-18) fluoro-2-deoxy-D-glucose SPECT. Radiology 199:761–766
Nystrom SJ, Weiner JM, Wolf RM, Bateman JR, Viola MV (1979) Identifying the primary site in metastatic cancer of unknown origin. Inadequacy of roentgenographic procedures. JAMA 241:381–383
Panza N, Lombardi G, Rosa M, Pacilio G, Lapenta L, Salvatore M (1987) High serum thyroglobulin levels, diagnostic indicators in patients from unknown primary sites. Cancer 60:2233–2236
Rege S, Maass A, Chaiken L, et al (1994) Use positron emission tomography with fluorodeoxyglucose in patients with extracranial head and neck cancers. Cancer 73:3047–3058
Scanlon EF (1985) The process of metastasis. Cancer 55:1163–1166
Schipper JH, Schrader M, Arweiler D, Müller S, Sciuk J (1996) Positron emission tomography to locate primary tumor in patients with cervical lymph node metastases from an occult tumor. HNO 44:254–257
Schomburg A, Hotze A, Walther E, Alberty J, Bender H, Herberhold C, Biersack HJ (1993) Radioimmunoimaging of head and neck cancer. Onkologie 16:465–469
Smith PE, Krementz ET, Chapman W (1967) Metastatic cancer without a detectable primary site. Am J Surg 113:633–637
Stewart JF, Tattersall MNH, Woods RL, Fox RM (1979) Unknown primary adenocarcinoma: incidence of overinvestigation and natural history. Br Med J 1:1530–1533
Talmadge JE, Fidler IJ (1982) Enhanced metastatic potential of tumor cells harvested from spontaneous metastases of heterogeneous murine tumors. JNCI 69:975–980
Uematsu H, Sadato N, Yonekura Y, Tsuchida T, Nakamura S, Sugimoto K, Waki A, Yamamoto K, Hayashi N, Ishii Y (1998) Coregistration of FDG PET and MRI of the head and neck using normal distribution of FDG. J Nucl Med 39:2121–2127
Van den Brekel MPM, Castelijns JA, Steel H, Golden RP, Meyer, Snow G (1993) Modern imaging techniques and ultrasound - guided aspiration cytology for the assessment of neck node metastasis. A prospective comoparative study. Eur Arch Otorhinolaryngol 250:11–17
Wang RC, Goepfert H, Barber AE, Wolf P (1990) Unknown primary squamous cell carcinoma metastatic to the neck. Arch Otolaryngol Head Neck Surg 116:1388–1393
zur Hausen H, Schulte-Holthausen H, Klein G, et al (1970) EBV DNA in biopsies of Burkitt tumors and anaplastic carcinomas of the nasopharynx. Nature 228:1056–1058
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Scheidhauer, K., Avril, N., Bonkowsky, V.M. (2000). Carcinoma of unknown primary. In: Wieler, H.J., Coleman, R.E. (eds) PET in Clinical Oncology. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57703-1_14
Download citation
DOI: https://doi.org/10.1007/978-3-642-57703-1_14
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-642-63329-4
Online ISBN: 978-3-642-57703-1
eBook Packages: Springer Book Archive