Carcinoma of Unknown Primary in Head and Neck Region

Česká verzia

Authors: Uhliarová Barbora ¹; Navrátilová Marcela ¹; Čalkovský Vladimír ²; Hajtman Andrej ²
Authors place of work: Oddelenie otorinolaryngológie FNsP FD Roosevelta, Banská Bystrica ¹; Klinika otorinolaryngológie a chirurgie hlavy a krku, UK JLF a UNM Martin ²
Published in the journal: Klin Onkol 2018; 31(4): 277-281
Category: Original Articles
doi: https://doi.org/10.14735/amko2018277

Summary

Introduction:
Carcinoma of unknown primary (CUP) in head and neck region is diagnosed in 5% of patients with malignant tumour of head and neck. In the management of patients with CUP, complex investigation to diagnose the occult tumour is always necessary. Detection of origin allows targeted specific treatment that significantly improves the prognosis of the disease.

Material and methods:
Retrospective analysis of patients treated at the Department of Otorhinolaryngology and Head and Neck Surgery of the UK JLF and UNM in Martin between January 2012 until September 2017 for CUP in head and neck region. Diagnostic procedure and success of primary tumour detection were evaluated.

Results:
In study group, there were 40 patients with average age 59.4 ± 1.5 years (35–78 years). CT scan and panendoscopic examination in general anaesthesia were performed in all patients. Ipsilateral tonsillectomy (TE) was performed in 34 patients (80%). For the remaining 6 patients, TE was not indicated – 2 found originally in the panendoscopic examination and in 4 TE was performed in the past. Blinded samples from the nasopharynx, the base of the tongue and the pyriform recess were taken in 38 patients (95%). PET/CT screening was indicated in 12 patients (30%). The primary tumour did not detect the primary tumour in any of them. Primary tumour was diagnosed in 21 cases (52.5%). In 16 patients (40%), the primary tumour was found in the upper aerodigestive tract, in 5 patients (12.5%) the primary tumour was located outside the ENT region. The primary tumour was not identified in 19 cases (47.5%). Conclusion: Despite the modern imaging and endoscopic methods, the primary tumour cannot always be identified.

Keywords:
metastasis into cervical lymph nodes – carcinoma of unknown primary – diagnosis – PET/CT – panendoscopy

The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Submitted: 3. 1. 2018

Accepted: 18. 6. 2018

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