Der Onkologe

, Volume 13, Issue 7, pp 645–654 | Cite as

Carcinoma of unknown primary (CUP-Syndrom)

Metastasen eines unbekannten Primärtumors
CME Weiterbildung • Zertifizierte Fortbildung

Zusammenfassung

Die Diagnose eines malignen Tumors erlaubt nicht immer die Lokalisation des Primärtumors. Patienten mit einem Karzinom unbekannter Primärlokalisation („carcinoma of unknown primary“, CUP) stellen den behandelnden Arzt oft vor ein schwieriges diagnostisches und therapeutisches Problem. Es existiert keine allgemein akzeptierte Definition des CUP-Syndroms. Die Besonderheiten dieser Entität bestehen in atypischem Metastasierungsmuster und ungewöhnlicher Wachstumskinetik. Die Feststellung einer Metastase, die nicht eindeutig einem Primärtumor zuzuordnen ist, sollte begrenzte diagnostische Maßnahmen zur Folge haben, die sich sowohl hinsichtlich des Umfangs als auch bei der Auswahl der einzelnen Maßnahmen an den möglichen therapeutischen Konsequenzen orientieren sollten. Bei der Behandlung des CUP kommt es zunächst entscheidend darauf an, potenziell kurative (z. B. extragonadale Keimzelltumoren, atypische maligne Lymphome) oder zumindest gut behandelbare Tumormanifestationen (z. B. neuroendokrine Tumoren) zu erfassen und einer adäquaten Therapie zuzuführen. Ansonsten stehen je nach Ausdehnung chirurgische, strahlentherapeutische oder systemische Therapiemaßnahmen zur Verfügung. Für die große Mehrheit der Patienten mit CUP-Syndrom ist die Prognose mit einer Überlebenszeit von 3–11 Monaten allerdings ungünstig. Nur etwa 15% der Patienten überleben ein Jahr nach der Diagnose.

Schlüsselwörter

CUP-Syndrom Unbekannter Primärtumor Metastasen Primärtumorsuche 

Carcinoma of unknown primary (CUP-syndrome): metastases of unknown primary tumor

Abstract

The diagnosis of cancer is not necessarily linked to the identification of the primary malignancy. Clinicians treating patients with carcinoma of unknown primary (CUP) are often facing diagnostic and therapeutic difficulties. Foremost, there is no generally accepted definition of CUP-syndromes. One of the most striking features of this type of cancer is an atypical pattern of metastases associated with an unusual growth behavior. After detection of metastatic disease without a corresponding primary tumor, limited diagnostic effort should focus on potential therapeutic strategies. First of all, potentially curative tumor types (e. g. extragonadal germ cell cancer, atypical malignant lymphoma), or at least potentially chemo-sensitive cancers should be recognized and adequately treated. Otherwise, various treatment options like surgery, radiotherapy and other medical strategies should be considered. However, the vast majority of patients with CUP-syndrome have a poor prognosis with a median survival time of 3–11 months. Population-based analyses showed that only 15% of all patients with CUP-syndrome survive the first year after diagnosis.

Keywords

CUP-syndrome Carcinoma of unknown primary Metastases Unknown primary cancer 

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Copyright information

© Springer Medizin Verlag 2007

Authors and Affiliations

  1. 1.Medizinische Klinik IIIMarienhospital HerneHerneDeutschland
  2. 2.Chirurgische KlinikMarienhospital HerneHerneDeutschland
  3. 3.Klinik für Strahlentherapie und Radio-OnkologieMarienhospital HerneHerneDeutschland

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