Cervical lymph node metastases from squamous cell or undifferentiated unknown primary tumors (CUP) are rare, constituting 2–3% of all new head and neck cancers. The management of these patients remains a major challenge in oncology. The diagnosis of CUP relies on the absence of a primary tumor after the completion of an extensive workup. Recent developments in imaging and pathology have increased our diagnostic spectrum considerably, but the impact of these techniques on decision-making has not been well documented. The selection and timing of the diagnostic measures in the workup process are still under debate, and the choice of treatment is controversial. Treatment options and recommendations vary from surgery alone in selected cases, limited fi eld radiotherapy, where only the ipsilateral neck is treated, or extensive prophylactic irradiation of all potential mucosal sites as well as both sides of the neck. While these strategies may differ in the rate of emerging primary tumors and morbidity, no randomized or prospective studies are available to support either of these approaches in particular. These issues are summarized and discussed in this chapter. More detailed reviews are given in Jereczek-Fossa et al. (2004) and Nieder et al. (2001).
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Grau, C. (2009). Cervical Lymph Node Metastases from Unknown Primary Tumors. In: Harari, P.M., Connor, N.P., Grau, C. (eds) Functional Preservation and Quality of Life in Head and Neck Radiotherapy. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-73232-7_10
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