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1. Lee SH, Kim MJ, Lee HJ, Kim SJ, Park JS, Hur SY: A case of inguinal lymph node squamous cell carcinoma of unknown origin, accompanied with carcinoma in situ of cervix. J Gynecol Oncol; 2008 Jun;19(2):145-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A case of inguinal lymph node squamous cell carcinoma of unknown origin, accompanied with carcinoma in situ of cervix.
  • Metastatic Cancer of Unknown Primary Site (CUP) accounts for approximately 3-5% of all malignant neoplasms.
  • CUP represents a heterogeneous group of metastatic tumors for which no primary site can be detected following a thorough medical history, careful clinical examination, and extensive diagnostic work-up.
  • Several authors have reported poor prognosis of this malignancy, because there is no consensus on diagnostic guidelines and optimal therapy.
  • Historically, chemotherapy has been the cornerstone of treatment for patients with CUP.
  • We experienced a case of inguinal lymph node squamous cell carcinoma of unknown origin, accompanied with carcinoma in situ of the cervix.

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  • (PMID = 19471557.001).
  • [ISSN] 2005-0380
  • [Journal-full-title] Journal of gynecologic oncology
  • [ISO-abbreviation] J Gynecol Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2676454
  • [Keywords] NOTNLM ; Inguinal lymph node / Metastatic cancer of unknown primary site
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2. Calabrese L, Jereczek-Fossa BA, Jassem J, Rocca A, Bruschini R, Orecchia R, Chiesa F: Diagnosis and management of neck metastases from an unknown primary. Acta Otorhinolaryngol Ital; 2005 Feb;25(1):2-12
MedlinePlus Health Information. consumer health - Head and Neck Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis and management of neck metastases from an unknown primary.
  • Neck lymph node metastases from occult primary constitute about 5%-10% of all patients with carcinoma of unknown primary site.
  • Diagnostic procedures include a careful clinical evaluation and a fiberoptic endoscopic examination of the head and neck mucosa, biopsies from all suspicious sites or blindly from the sites of possible origin of the primary, computerized tomography scan, and magnetic resonance.
  • The most frequent histological finding is Squamous Cell Carcinoma, particularly when the upper neck is involved.
  • In these cases, a systematic tonsillectomy in the absence of suspicious lesions is discussed since up to 25% of primary tumours can be detected in this site.
  • Positron emission tomography with fluoro-2-deoxy-D-glucose allows detection of primary tumour in about 25% of cases, but this procedure is still considered investigational.
  • Therapeutic approaches include surgery (neck dissection), with or without post-operative radiotherapy, radiotherapy alone and radiotherapy followed by surgery as reported by several guide-lines.
  • A potential benefit from extensive radiotherapy should be weighed against its acute and late morbidity and difficulties in re-irradiation in the case of subsequent primary emergence.
  • The role of other methods, such as chemotherapy and hyperthermia, remains to be determined.
  • [MeSH-major] Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / secondary. Head and Neck Neoplasms / diagnosis. Head and Neck Neoplasms / secondary. Neoplasms, Unknown Primary

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  • (PMID = 16080309.001).
  • [ISSN] 0392-100X
  • [Journal-full-title] Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
  • [ISO-abbreviation] Acta Otorhinolaryngol Ital
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 102
  • [Other-IDs] NLM/ PMC2639847
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3. Lu X, Hu C, Ji Q, Shen C, Feng Y: Squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site: the impact of radiotherapy. Tumori; 2009 Mar-Apr;95(2):185-90
MedlinePlus Health Information. consumer health - Head and Neck Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site: the impact of radiotherapy.
  • AIMS AND BACKGROUND: Cervical lymph node metastases of squamous cell carcinoma from an unknown primary site constitute about 5% of the total head and neck cancer, cases.
  • The management of these patients is still a therapeutic challenge.
  • METHODS AND STUDY DESIGN: Data from 60 patients with cervical lymph node metastases of squamous cell carcinoma from an unknown primary site were reviewed.
  • Fourteen patients (23.3%) also received chemotherapy.
  • Emergence of the occult primary was observed in 21.2% patients, and all of these occurred within the head and neck region.
  • The primary tumor emerged in 23.3% of patients treated with ipsilateral and bilateral neck irradiation and in 12.5% of patients irradiated by extensive field (P = 0.469).
  • CONCLUSIONS: Patients with cervical lymph node metastases of squamous cell carcinoma from an unknown primary site have clinical features and a prognosis similar to those of other head and neck malignancies.
  • Extensive irradiation results in a lower trend of emergence of the primary tumor than when patients are treated with ipsilateral and bilateral irradiation, but there is no significant difference in overall survival.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / secondary. Head and Neck Neoplasms / pathology. Head and Neck Neoplasms / radiotherapy. Lymph Nodes / pathology. Lymph Nodes / radiation effects. Neoplasms, Unknown Primary / pathology. Neoplasms, Unknown Primary / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Female. Humans. Kaplan-Meier Estimate. Lymphatic Metastasis. Male. Middle Aged. Multivariate Analysis. Neck. Neck Dissection. Neoplasm Staging. Prognosis. Radiotherapy / methods

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  • (PMID = 19579864.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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4. Watanabe S, Tanaka J, Tsuboi K, Tanaka H, Kagamu H, Yoshizawa H, Suzuki E, Gejyo F: [A case of squamous cell carcinoma of unknown primary site with involvement of cervico-mediastinal lymph nodes successfully treated by chemoradiotherapy]. Gan To Kagaku Ryoho; 2006 Oct;33(10):1493-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [A case of squamous cell carcinoma of unknown primary site with involvement of cervico-mediastinal lymph nodes successfully treated by chemoradiotherapy].
  • A 70-year-old woman was admitted with cervicomediastinal lymph node metastases from squamous cell carcinoma of unknown primary site (Sq-CUPS).
  • The patient was treated with 4 cycles of chemotherapy combining carboplatin and paclitaxel with subsequent radiation therapy.
  • After serial treatment, a partial response was obtained, and the disease has not recurred for over 2 years.
  • Chemotherapy with carboplatin and paclitaxel followed by sequential radiation therapy was suggested to be potentially useful for Sq-CUPS with involvement of cervicomediastinal lymph nodes, although this group of patients is generally regarded to have a poor prognosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Lymph Nodes / pathology. Neoplasms, Unknown Primary / drug therapy. Neoplasms, Unknown Primary / radiotherapy
  • [MeSH-minor] Aged. Carboplatin / administration & dosage. Combined Modality Therapy. Drug Administration Routes. Female. Humans. Lymphatic Metastasis. Mediastinum. Neck. Paclitaxel / administration & dosage

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  • (PMID = 17033245.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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5. Alvarez Marcos CA, Llorente Pendás JL, Franco Gutiérrez V, Hermsen M, Cuesta Albalad MP, Fernández Espina H, Suárez Nieto C: [Distant metastases in head and neck cancer]. Acta Otorrinolaringol Esp; 2006 Oct;57(8):369-72
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • INTRODUCTION: The presence of distant metastasis (DM) after the initial treatment of head and neck squamous cell carcinoma (HNSCC) is not considered a common event and it is associated to a poor outcome.
  • RESULTS: During the follow-up period after the initial treatment, 6.2% of the patients were diagnosed of having distant metastasis.
  • The site of primary tumor was hypopharynx in 14.4%, unknown origin in 11.8% and oropharynx in 8.5%.
  • There is a need of guidelines for screening of distant metastases in patients with HNSCC in order to get an early diagnosis and a more effective treatment.
  • Because of the poor prognosis of DM, protocols including adjuvant chemotherapy should be investigated.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Head and Neck Neoplasms / pathology

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  • (PMID = 17117695.001).
  • [ISSN] 0001-6519
  • [Journal-full-title] Acta otorrinolaringológica española
  • [ISO-abbreviation] Acta Otorrinolaringol Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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6. Gevaert O, Daemen A, De Moor B, Libbrecht L: A taxonomy of epithelial human cancer and their metastases. BMC Med Genomics; 2009;2:69
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  • This technology has the potential to individualize therapy and to discover new drug targets.
  • However, due to technological differences and issues in standardized sample collection no study has evaluated the molecular profile of epithelial human cancer in a large number of samples and tissues.
  • Additionally, it has not yet been extensively investigated whether metastases resemble their tissue of origin or tissue of destination.
  • METHODS: We studied the expression profiles of a series of 1566 primary and 178 metastases by unsupervised hierarchical clustering.
  • RESULTS: Large clusters corresponding to breast, gastrointestinal, ovarian and kidney primary tissues emerged from the data.
  • Chromophobe renal cell carcinoma clustered together with follicular differentiated thyroid carcinoma, which supports recent morphological descriptions of thyroid follicular carcinoma-like tumors in the kidney and suggests that they represent a subtype of chromophobe carcinoma.
  • We also found an expression signature identifying primary tumors of squamous cell histology in multiple tissues.
  • Moreover, a signature was developed based on our unsupervised clustering of breast tumors and this was predictive for disease-specific survival in three independent studies.
  • Next, the metastases from ovarian, breast, lung and vulva cluster with their tissue of origin while metastases from colon showed a bimodal distribution.
  • A significant part clusters with tissue of origin while the remaining tumors cluster with the tissue of destination.
  • CONCLUSION: Our molecular taxonomy of epithelial human cancer indicates surprising correlations over tissues.
  • Additionally, we hypothesize that metastases from gastrointestinal origin either remember their tissue of origin or adapt to the tissue of destination.
  • More specifically, colon metastases in the liver show strong evidence for such a bimodal tissue specific profile.
  • [MeSH-minor] Cluster Analysis. Gene Expression Profiling. Genomics. Humans. Internationality. Neoplasms, Unknown Primary / therapy. Oligonucleotide Array Sequence Analysis

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  • (PMID = 20017941.001).
  • [ISSN] 1755-8794
  • [Journal-full-title] BMC medical genomics
  • [ISO-abbreviation] BMC Med Genomics
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2806369
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7. Larsen CR, Hansen PB, Clausen NT: Aggressive growth of epithelial carcinomas following treatment with nucleoside analogues. Am J Hematol; 2002 May;70(1):48-50
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  • [Title] Aggressive growth of epithelial carcinomas following treatment with nucleoside analogues.
  • Two patients, one with B-cell chronic lymphocytic leukemia (CLL) and one with hairy-cell leukemia (HCL), were treated with immunosuppressive chemotherapy.
  • The patient with CLL was a 54-year-old female, who had had a squamous cell carcinoma (SCC) excised from her forehead 5 months before receiving the first course of fludarabine.
  • During the fludarabine treatment, the patient developed a local SCC relapse and metastases in the neck.
  • The carcinoma was treated by excision and radiotherapy, and further fludarabine treatment was withheld.
  • Nevertheless, the SCC metastasized aggressively and the patient died 3 months after the start of fludarabine treatment, primarily due to respiratory failure.
  • At the time of diagnosis of HCL, the patient had two solid tumors in the liver containing poorly differentiated epithelial carcinoma cells of unknown origin.
  • During treatment with 2-chlorodeoxyadenosine (2CdA), the tumors in the liver rapidly spread in multiple intrahepatic metastases, followed by liver failure and death within 1 month.
  • Fludarabine and 2CdA cause a substantial suppression of all lymphocyte subsets, in particular the T-cell line.
  • It is therefore assumed that fludarabine and 2CdA in these two cases triggered an exacerbation of both tumors due to the T-cell depletion.
  • [MeSH-major] 2-Chloroadenosine / therapeutic use. Antineoplastic Agents / therapeutic use. Immunosuppressive Agents / therapeutic use. Leukemia, Hairy Cell / drug therapy. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Liver Neoplasms / drug therapy. Nucleosides / therapeutic use. Vidarabine / therapeutic use
  • [MeSH-minor] Aged. Carcinoma, Squamous Cell / secondary. Carcinoma, Squamous Cell / surgery. Female. Head and Neck Neoplasms / secondary. Head and Neck Neoplasms / surgery. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasms, Multiple Primary. Neoplasms, Second Primary

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • (PMID = 11994981.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Immunosuppressive Agents; 0 / Nucleosides; 146-77-0 / 2-Chloroadenosine; FA2DM6879K / Vidarabine; P2K93U8740 / fludarabine
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8. Werner JA, Dünne AA: Value of neck dissection in patients with squamous cell carcinoma of unknown primary. Onkologie; 2001 Feb;24(1):16-20
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  • [Title] Value of neck dissection in patients with squamous cell carcinoma of unknown primary.
  • Lymph node metastases of cancer of an unknown primary (CUP syndrome) are responsible for 3-5% of the malignant diseases in the head and neck area.
  • More than 70% of these patients show lymph node metastases of an unknown squamous cell carcinoma.
  • For a curative approach modified radical neck dissection combined with postoperative radiation therapy with or without chemotherapy should be considered in N1-N3 lymph node status.
  • A radical neck dissection with postoperative radiation therapy should only be approved in cases of infiltration of the internal jugular vein, the accessory nerve and/or the sternocleidomastoid muscle.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Head and Neck Neoplasms / secondary. Lymphatic Metastasis / pathology. Neck Dissection. Neoplasms, Unknown Primary / surgery

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  • [Copyright] Copyright 2001 S. Karger GmbH, Freiburg
  • (PMID = 11441275.001).
  • [ISSN] 0378-584X
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 37
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9. Yamashita S, Hirao M, Tsujinaka T, Sawamura T, Nakamori S, Mishima H, Fujitani K, Ikenaga M, Kashiwazaki M, Masuda N: [A case of unknown primary squamous cell carcinoma in the neck showing a high response with combined chemotherapy including nedaplatin, adriamycin and 5-fluorouracil]. Gan To Kagaku Ryoho; 2005 Aug;32(8):1149-51
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  • [Title] [A case of unknown primary squamous cell carcinoma in the neck showing a high response with combined chemotherapy including nedaplatin, adriamycin and 5-fluorouracil].
  • We report a case of a 54-year-old man with unknown primary squamous cell carcinoma in the bilateral neck.
  • The patient was treated with chemotherapy and radiation therapy, because his right common carotid artery was invaded by the right neck tumor, and a complete curative operation was not considered possible.
  • We chose instead combination chemotherapy with nedaplatin, adriamycin and 5-fluorouracil (NAF), because it was reported that NAF was available for advanced squamous cell carcinoma of the esophagus.
  • After 3 cycles of NAF chemotherapy, the patient showed a partial response of approximately an 86% decrease in the right neck tumor for over three months.
  • In addition to NAF, radiation therapy was performed.
  • In the CT findings after chemotherapy and radiation therapy, the patient showed a complete response in the bilateral neck tumors.
  • Unknown primary squamous cell carcinoma in the neck has been treated by combination therapy consisting of chemotherapy, radiation therapy and surgery.
  • The regime of 5-fluorouracil and cisplatin is said to be an effective treatment for unknown primary squamous cell carcinoma in the neck.
  • Based on our experience, NAF would be available as chemotherapy for unknown primary squamous cell carcinomas in the neck.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Head and Neck Neoplasms / drug therapy. Neoplasms, Unknown Primary
  • [MeSH-minor] Antibiotics, Antineoplastic / administration & dosage. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Combined Modality Therapy. Doxorubicin / administration & dosage. Fluorouracil / administration & dosage. Humans. Male. Middle Aged. Neoplasm Invasiveness. Organoplatinum Compounds / administration & dosage

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  • (PMID = 16121918.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 80168379AG / Doxorubicin; 8UQ3W6JXAN / nedaplatin; U3P01618RT / Fluorouracil
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10. Kuemper C, Burges A, Hillemanns P, Mueller-Egloff S, Lenhard M, Ditsch N, Strauss A: Supraclavicular lymph node metastases of unknown origin: HPV-typing identifies the primary tumour. Eur J Cancer Care (Engl); 2009 Nov;18(6):606-11
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  • [Title] Supraclavicular lymph node metastases of unknown origin: HPV-typing identifies the primary tumour.
  • Cancers of unknown primary origin (CUP) account for 0.5-10% of all malignancies.
  • CUP patients with metastases have a median survival of approximately 6 months, despite therapy.
  • Identification of the primary tumour site may offer the opportunity of a specific and more efficient treatment.
  • The case of a 45-year-old woman with supraclavicular lymph node metastases of a squamous cell CUP is reported.
  • Human papillomavirus (HPV)-testing in the tissues revealed the tumour cells as metastases of an occult cervical cancer.
  • Primary platin-based chemotherapy combined with paclitaxel leads to a complete apparative remission.
  • Twelve months later, staging positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose in combination with computed tomography identified an isolated left renal lymph node metastasis.
  • The patient received targeted radiation therapy, combined with cisplatin.
  • The presented case report addresses the difficulties involving the identification of CUP.
  • As the presented case illustrates, testing for this virus DNA in human tissues can be a useful diagnostic tool in patients with CUP where cervical cancer is the possible primary tumour.
  • [MeSH-major] Carcinoma, Squamous Cell / diagnosis. Human papillomavirus 16 / genetics. Neoplasms, Unknown Primary / diagnosis. Uterine Cervical Neoplasms / diagnosis
  • [MeSH-minor] Antineoplastic Agents, Phytogenic / therapeutic use. Biopsy. DNA, Viral / genetics. Female. Humans. Incidental Findings. Lymphatic Metastasis. Middle Aged. Paclitaxel / therapeutic use. Positron-Emission Tomography

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  • (PMID = 19549285.001).
  • [ISSN] 1365-2354
  • [Journal-full-title] European journal of cancer care
  • [ISO-abbreviation] Eur J Cancer Care (Engl)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 0 / DNA, Viral; P88XT4IS4D / Paclitaxel
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11. Jereczek-Fossa BA, Jassem J, Orecchia R: Cervical lymph node metastases of squamous cell carcinoma from an unknown primary. Cancer Treat Rev; 2004 Apr;30(2):153-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cervical lymph node metastases of squamous cell carcinoma from an unknown primary.
  • Cervical lymph node metastases of squamous cell carcinoma from occult primary constitute about 2-5% of all patients with carcinoma of unknown primary site (CUP).
  • Metastases in the upper and middle neck are generally attributed to head and neck cancers, whereas the lower neck (supraclavicular area) involvement is often associated with primary malignancies below the clavicles.
  • The diagnostic procedures include physical examination with thorough evaluation of the head and neck mucosa using fiber-optic endoscopy, biopsies from all suspicious sites or blindly from the sites of possible origin of the primary, computer tomography and/or magnetic resonance.
  • A systematic tonsillectomy in the absence of suspicious lesions is often recommended since up to 25% of primary tumors can be detected in this site.
  • The thoracic primary (tracheal, bronchial, lung, esophagus) has to be excluded, especially in the case of lower neck involvement.
  • Positron emission tomography (PET) with fluoro-2-deoxy-D-glucose allows detection of primary tumor in about 25% of cases, but this procedure is still considered investigational.
  • Therapeutic approaches include surgery (lymph node excision or neck dissection), with or without postoperative radiotherapy, radiotherapy alone and radiotherapy followed by surgery.
  • A potential benefit from extensive radiotherapy should be weighted against its acute and late morbidity and difficulties in re-irradiation in the case of subsequent primary emergence.
  • The role of other methods, such as chemotherapy and hyperthermia, remains to be determined.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Head and Neck Neoplasms / pathology. Lymph Nodes / pathology. Neoplasms, Unknown Primary / pathology
  • [MeSH-minor] Humans. Lymph Node Excision. Lymphatic Metastasis. Neck. Prognosis. Treatment Failure

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  • (PMID = 15023433.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 91
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12. Pavlidis N, Pentheroudakis G, Plataniotis G: Cervical lymph node metastases of squamous cell carcinoma from an unknown primary site: a favourable prognosis subset of patients with CUP. Clin Transl Oncol; 2009 Jun;11(6):340-8
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  • [Title] Cervical lymph node metastases of squamous cell carcinoma from an unknown primary site: a favourable prognosis subset of patients with CUP.
  • Squamous cervical cancer of unknown primary site (SQCCUP) presents in patients as neck lymph nodes involved by squamous carcinoma in the absence of identifiable primary in the head, neck or lung.
  • This CUP subset affects male patients previously exposed to alcohol and tobacco, though a proportion of cases may be related to chronic infection of the oropharynx by human papilloma virus.
  • The cornerstones of management are excisional biopsy or surgical extirpation of the disease followed by bilateral neck external beam radiotherapy and chemotherapy.
  • The necessity for complete surgical resection of involved neck nodes, irradiation of all head/neck mucosal sites and administration of concurrent chemotherapy is currently being debated.
  • Aggressive multimodal therapy results in longterm disease control in 50-60% of patients, though data are mainly based on retrospective cohorts.
  • Recently introduced molecular profiling platforms may provide biological classification to a primary tissue of origin as well as insights into the pathophysiology of this clinical entity.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Lymphatic Metastasis. Neoplasms, Unknown Primary / pathology
  • [MeSH-minor] Alcoholism / epidemiology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor. Clinical Trials as Topic. Combined Modality Therapy. Diagnostic Imaging. Female. Gene Expression Profiling. Humans. Lymph Node Excision. Male. Neck. Neck Dissection. Neoplasm Recurrence, Local. Prognosis. Radiotherapy, Adjuvant / methods. Risk Factors. Smoking / epidemiology. Tonsillectomy

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  • (PMID = 19531448.001).
  • [ISSN] 1699-3055
  • [Journal-full-title] Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
  • [ISO-abbreviation] Clin Transl Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 58
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13. Blaszyk H, Hartmann A, Bjornsson J: Cancer of unknown primary: clinicopathologic correlations. APMIS; 2003 Dec;111(12):1089-94
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  • [Title] Cancer of unknown primary: clinicopathologic correlations.
  • Cancer of unknown primary origin (CUP) accounts for 5-10% of all malignant tumors at presentation and remains the death certificate diagnosis in 0.5-5% of patients.
  • We investigated CUP patients whose primary site remained unknown throughout the entire clinical course.
  • We reviewed 9,436 consecutive autopsies performed between 1984 and 1999 at the Mayo Clinic, matched with 177,167 cancer patients treated in the same time period.
  • Sixty-four patients who died of CUP underwent postmortem examination.
  • Antemortem pathologic diagnoses were obtained in 57 patients, agreed with postmortem diagnoses in 98%, and included adenocarcinoma (n=44), undifferentiated carcinoma (n=7), squamous cell carcinoma (n=3), and others (n=3).
  • Autopsy located the primary site in 35 patients (55%).
  • Common primary sites were lung (n=8), the pancreaticobiliary (n=13) and GI tracts (n=9).
  • Of 43 patients evaluated for tumor-specific therapy, only six received no further oncologic treatment and untreated patients survived a median of 57 (range 10-280) days, compared with 225 (range 19-1,129) days for patients treated with chemotherapy and/or radiotherapy (n=37).
  • Our findings show that (1) autopsy studies provide a valuable tool for quality control in the setting of CUP, and (2) treated patients have a small but significant survival benefit.
  • [MeSH-major] Adenocarcinoma / secondary. Carcinoma, Neuroendocrine / secondary. Carcinoma, Squamous Cell / secondary. Neoplasms, Unknown Primary / pathology

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  • (PMID = 14678017.001).
  • [ISSN] 0903-4641
  • [Journal-full-title] APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
  • [ISO-abbreviation] APMIS
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Denmark
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14. Issing WJ, Taleban B, Tauber S: [Diagnosis and management of squamous cell carcinoma of the head and neck region with unknown primary. A survey of 167 patients]. Laryngorhinootologie; 2003 Sep;82(9):659-65
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  • [Title] [Diagnosis and management of squamous cell carcinoma of the head and neck region with unknown primary. A survey of 167 patients].
  • [Transliterated title] Diagnose und Management von Plattenepithelkarzinomen mit unbekanntem Primärtumor im Kopf-Hals-Bereich.
  • BACKGROUND: Carcinoma of unknown primary is defined as histological diagnosis of metastasis without diagnosis of a primary tumor.
  • The incidence of CUP is stated in the literature between 3 % and 15 % of all patients with an malignant disease.
  • Histological examination of CUP-metastasis of the neck most frequently shows a squamous cell carcinoma.
  • PATIENTS AND METHODS: The study included 167 patients admitted and treated for cervical CUP at the department of Oto-Rhino-Laryngology, Klinikum Grosshadern from 1979 to 1998.
  • In the studied collective squamous cell carcinoma had the highest incidence (n = 123).
  • During the 10 year follow-up a primary tumor was found in 36 of the 167 initially diagnosed CUP-patients.
  • The origin of the tumor was most frequently the tonsilla palatina (n = 7).
  • Primary radiotherapy was the treatment of choice in 28 patients, 8 patients received combined radio-chemotherapy as primary treatment and 7 patients were treated with chemotherapy alone.
  • No treatment was performed in 6 patients.
  • RESULTS: By comparing the treatment methods there was a significant difference of patient survival in regard to the treatment.
  • Patients treated according to treatment-plan II, which includes an additional "diagnostic" tonsillectomy, is significantly higher than that of patients simply undergoing neck dissection and postoperative radiotherapy or primary radiotherapy alone.
  • Treatment of choice in patients with cervical CUP should be a surgical procedure including radical neck dissection and diagnostic bilateral tonsillectomy followed by postoperative radiation of the cervical lymph drainage.
  • DISCUSSION: Bilateral tonsillectomy is especially important and is correlated with a significant improvement of the survival rate in CUP patients.
  • Additional postoperative radiation of the pharynx from the base of the skull to the upper oesophagus should also be considered, in order to treat a possible--small--primary tumor in this region.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Head and Neck Neoplasms / secondary. Neoplasms, Unknown Primary
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Data Interpretation, Statistical. Female. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Neck Dissection. Retrospective Studies. Survival Analysis. Time Factors. Tonsillar Neoplasms / surgery. Tonsillectomy

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  • (PMID = 14517763.001).
  • [ISSN] 0935-8943
  • [Journal-full-title] Laryngo- rhino- otologie
  • [ISO-abbreviation] Laryngorhinootologie
  • [Language] ger
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Germany
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15. Pejcić I, Vrbić S, Filipović S, Sćekić M, Petković I, Pejcić L, Djenić N: [Significance of serum tumor markers monitoring metastases in carcinomas of unknown primary site]. Vojnosanit Pregl; 2010 Sep;67(9):723-31
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  • [Title] [Significance of serum tumor markers monitoring metastases in carcinomas of unknown primary site].
  • BACKGROUND/AIM: Unknown primary tumors represent a heterogeneous group of malignancies that are indicative of ominous prognosis.
  • Cancer of unknown primary site (CUP) is defined as the lack of any detectable primary site after full evaluation, and accounts for approximately 3-5% of all newly diagnosed patients with malignancies.
  • On histological examination, all the patients were presented with metastatic tumors whose primary site (origin) could not be detected with noninvasive diagnostic techniques.
  • Following the routine light microscopy, all histological findings were classified into one of the following three groups: plano-cellular carcinoma--8 patients; adenocarcinoma--33 patients; unclassifiable (undifferentiated) carcinoma--22 patients.
  • In all the cases we evaluated 8 serum tumor markers: alpha-fetoproteins (AFP), chronic gonadotrophin beta submit, human (beta-HCG), neuron specific enolase (NSE), marker of malignant ovarian tumors (CA 125), prostate-specific antigene (PSA), marker of malignant brest tumor (CA 15-3), marker of malignant pancreas tumor and gastrointestinal tumor (Ca 19-9), carcinoembryonic antigen (CEA) at the time of diagnosis.
  • The patients on chemotherapy had the markers determined after the third and sixth chemocycle, i.e. at the time of illness progression observation, if present.
  • The patients responding to chemotherapy with complete response (CR), partial response (PR) or stable disease (SD) had the markers determined after three-month periods until the time of relapse or progression.
  • Chemotherapy was applied in 32 patients (20 females and 12 males), aged 29-70 years, who met the inclusion criteria.
  • The following chemotherapy regimen was used: doxorubicin 50 mg/m2 (day 1), cisplatin 60 mg/m2 (day 1), and etoposide 120 mg/m2 (days 1-3).
  • The period between two chemotherapy cycles was three weeks, and maximum five weeks in the case of prolonged hematological toxicity.
  • Average survival time was 17.89 months (95% CI 12.96; 22.83).
  • The group of 32 patients treated with chemotherapy had 12 (37.5%) fatal outcomes in the observed period (72 months).
  • Average survival time was 26.6 months (95% CI 19.5; 33.7).
  • Average tumor marker values before and after the chemotherapy were significantly lower for NSE and CA 125.
  • CONCLUSION: Increased values of serum tumor markers are very often in CUP.
  • The NSE and CA 125 levels show good correlation with response to the given chemotherapy.
  • [MeSH-major] Adenocarcinoma / secondary. Biomarkers, Tumor / blood. Carcinoma / secondary. Carcinoma, Squamous Cell / secondary. Neoplasms, Unknown Primary / pathology


16. Kruk-Zagajewska A, Szmeja Z, Wierzbicka M: [Neck metastases from unknown primary neoplasms (CUP syndrome)]. Otolaryngol Pol; 2000;54 Suppl 31:262-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Neck metastases from unknown primary neoplasms (CUP syndrome)].
  • [Transliterated title] Przerzuty w układzie chłonnym szyi z nieznanego ogniska nowotworowego (carcinoma of unknown primary--CUP syndrom).
  • Carcinoma of unknown primary (CUP-syndrome) is taken into consideration when the patient has histologically confirmed metastases but the primary focus remains unknown or it's diagnosis is delayed.
  • Metastases of unknown origin constitute from 5% to 31% of all neck metastases.
  • Squamous cell carcinoma and anaplastic carcinoma metastases in the neck lymphatics suggest that location of primary focus can be found in head and neck region.
  • Diagnostic procedures applied in detection of primary foci have been described.
  • The knowledge of lymphatic metastases spreading routes is helpful in the primary focus detection.
  • In the material of 1348 patients treated oncologically in the years 1991-1997 in ENT Department of Karol Marcinkowski University of Medical Sciences in Poznań, 22 were diagnosed for CUP syndrome.
  • Primary foci were not found in 7 cases.
  • In the remaining 15 patients the primary was located in nasopharynx, palatinal tonsil, tongue, hypopharynx, testes or breast.
  • The treatment included the radical neck dissection with consecutive irradiation and/or chemotherapy, and in the case of diagnosing the primary one applied it's radical removal or radiotherapy.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Neoplasms, Unknown Primary

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  • (PMID = 10974902.001).
  • [ISSN] 0030-6657
  • [Journal-full-title] Otolaryngologia polska = The Polish otolaryngology
  • [ISO-abbreviation] Otolaryngol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] POLAND
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17. Sumi H, Itoh K, Onozawa Y, Shigeoka Y, Kodama K, Ishizawa K, Fujii H, Minami H, Igarashi T, Sasaki Y: Treatable subsets in cancer of unknown primary origin. Jpn J Cancer Res; 2001 Jun;92(6):704-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatable subsets in cancer of unknown primary origin.
  • The purpose of this study was to investigate the treatable subsets in cancer of unknown primary origin (CUP).
  • Fifty patients (27 males and 23 females; median age, 53 years) with CUP diagnosed between April 1992 and June 1999 were analyzed retrospectively.
  • Of the 50 patients, 39 received chemotherapy: platinum-based in 31, non-platinum-based in 4, and clinical trials of new agents in 4.
  • Patients with poorly differentiated carcinomas in whom beta-subunit of human chorionic gonadotropin (beta-HCG) was elevated more than 10 mIU / ml and female patients with peritoneal adenocarcinomatosis achieved high response rates (83.3% and 80%, respectively) with platinum-based chemotherapy, as compared with only a 15.3% response rate in the remaining patients.
  • Platinum-based chemotherapy provided promising results in patients with poorly differentiated carcinomas and in female patients with peritoneal adenocarcinomatosis.
  • Significantly elevated serum levels of beta-HCG in patients with poorly differentiated carcinoma might predict a better response to platinum-based chemotherapy.
  • However, the investigation of novel chemotherapeutic approaches is warranted for other groups of patients with CUP.
  • [MeSH-major] Chorionic Gonadotropin, beta Subunit, Human / blood. Neoplasms, Unknown Primary / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Female. Humans. Male. Middle Aged. Peritoneal Neoplasms / drug therapy. Sex Factors. Time Factors

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  • (PMID = 11429061.001).
  • [ISSN] 0910-5050
  • [Journal-full-title] Japanese journal of cancer research : Gann
  • [ISO-abbreviation] Jpn. J. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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18. Kawamoto M, Kunisaki C, Kunihiro O, Kamiya N, Moriwaki Y, Akiyama H, Shimada H, Kono N, Nakatani Y, Kunisaki R: Basaloid cell carcinoma of the esophagus with a metastatic neck tumor of unknown origin: report of a case. Surg Today; 2003;33(7):529-32
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  • [Title] Basaloid cell carcinoma of the esophagus with a metastatic neck tumor of unknown origin: report of a case.
  • Aspiration biopsy revealed squamous cell carcinoma (SCC).
  • Histological findings revealed that the tumor in the middle thoracic esophagus was moderately differentiated SCC, and that the other tumor below it was basaloid cell carcinoma (BCC).
  • A diagnosis of poorly differentiated SCC of unknown origin was made for the neck tumor.
  • Postoperative recombinant chemotherapy with cisplatin and 5-fluorouracil was given for the unknown primary site, which we still have not identified.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Carcinoma, Transitional Cell / pathology. Esophageal Neoplasms / pathology. Head and Neck Neoplasms / secondary. Neoplasms, Unknown Primary

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  • (PMID = 14506999.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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19. Borghi E, La Francesca M, Gazzola L, Marchetti G, Zonato S, Foa P, d'Arminio Monforte A, Morace G: Rhodococcus equi infection in a patient with spinocellular carcinoma of unknown origin. J Med Microbiol; 2008 Nov;57(Pt 11):1431-3
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  • [Title] Rhodococcus equi infection in a patient with spinocellular carcinoma of unknown origin.
  • A Rhodococcus equi pulmonary infection in a 63-year-old man receiving chemotherapy and radiotherapy for spinocellular carcinoma is described.
  • [MeSH-major] Actinomycetales Infections / etiology. Carcinoma, Squamous Cell / complications. Neoplasms, Unknown Primary / complications. Rhodococcus equi

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  • (PMID = 18927425.001).
  • [ISSN] 0022-2615
  • [Journal-full-title] Journal of medical microbiology
  • [ISO-abbreviation] J. Med. Microbiol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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20. Issing WJ, Taleban B, Tauber S: Diagnosis and management of carcinoma of unknown primary in the head and neck. Eur Arch Otorhinolaryngol; 2003 Sep;260(8):436-43
MedlinePlus Health Information. consumer health - Head and Neck Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnosis and management of carcinoma of unknown primary in the head and neck.
  • Carcinoma of unknown primary is defined as the histological diagnosis of metastasis without the detection of a primary tumor.
  • In the literature, the incidence of CUP in all patients with a malignant disease is said to be between 3% and 15%.
  • The most frequent histopathological results of CUP metastases are adenocarcinoma, followed by undifferentiated carcinoma and squamous cell carcinoma.
  • All patients had been admitted and treated for cervical CUP at the Department of Otorhinolaryngology of the Grosshadern Clinic from 1979 to 1998.
  • Squamous cell carcinoma (n=123) was the predominant histopathological finding of the cervical lymph nodes.
  • During the 10-year follow-up, a primary tumor was detected in 36 (21.5%) of the 167 initially diagnosed CUP patients.
  • The most frequent origin of the tumor was the tonsilla palatina (n=7).
  • Neck dissection and additional postoperative radiotherapy was performed in 118 (70.7%) of the 167 CUP patients.
  • Primary radiotherapy was the treatment of choice in 28 patients; eight patients received combined radio-chemotherapy as the primary treatment and seven patients were treated with chemotherapy alone.
  • Six patients had no treatment.
  • Comparison of different treatment protocols revealed a significant difference in patient survival: in comparison with primary radiotherapy alone or neck dissection and postoperative radiotherapy, the survival rate improved significantly in patients that received a bilateral tonsillectomy in addition to neck dissection and postoperative radiotherapy.
  • The treatment of choice in patients with cervical CUP should be a surgical procedure including (radical) neck dissection and diagnostic bilateral tonsillectomy followed by postoperative radiation of the cervical lymph drainage.
  • Bilateral tonsillectomy is especially important and is correlated with a significant improvement of the survival rate in CUP patients.
  • Additional postoperative radiation of the entire pharyngeal and laryngeal mucosa should also be considered in order to treat a possible small primary tumor in this region.
  • [MeSH-major] Carcinoma / secondary. Carcinoma / therapy. Head and Neck Neoplasms / secondary. Head and Neck Neoplasms / therapy. Neoplasms, Unknown Primary / diagnosis. Neoplasms, Unknown Primary / therapy

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  • (PMID = 12684829.001).
  • [ISSN] 0937-4477
  • [Journal-full-title] European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
  • [ISO-abbreviation] Eur Arch Otorhinolaryngol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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21. Pavlidis N, Briasoulis E, Hainsworth J, Greco FA: Diagnostic and therapeutic management of cancer of an unknown primary. Eur J Cancer; 2003 Sep;39(14):1990-2005
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnostic and therapeutic management of cancer of an unknown primary.
  • Metastatic Cancer of Unknown Primary Site (CUP) accounts for approximately 3% of all malignant neoplasms and is therefore one of the 10 most frequent cancer diagnoses in man.
  • Patients with CUP present with metastatic disease for which the site of origin cannot be identified at the time of diagnosis.
  • It is now accepted that CUP represents a heterogeneous group of malignancies that share a unique clinical behaviour and, presumably, unique biology.
  • The following clinicopathological entities have been recognised: (i) metastatic CUP primarily to the liver or to multiple sites, (ii) metastatic CUP to lymph nodes including the sub-sets involving primarily the mediastinal-retroperitoneal, the axillary, the cervical or the inguinal nodes, (iii) metastatic CUP of peritoneal cavity including the peritoneal papillary serous carcinomatosis in females and the peritoneal non-papillary carcinomatosis in males or females, (iv) metastatic CUP to the lungs with parenchymal metastases or isolated malignant pleural effusion, (v) metastatic CUP to the bones, (vi) metastatic CUP to the brain, (vii) metastatic neuroendocrine carcinomas and (viii) metastatic melanoma of an unknown primary.
  • Extensive work-up with specific pathology investigations (immunohistochemistry, electron microscopy, molecular diagnosis) and modern imaging technology (computed tomography (CT), mammography, Positron Emission Tomography (PET) scan) have resulted in some improvements in diagnosis; however, the primary site remains unknown in most patients, even on autopsy.
  • Several favourable sub-sets of CUP have been identified, which are responsive to systemic chemotherapy and/or locoregional treatment.
  • Identification and treatment of these patients is of paramount importance.
  • The considered responsive sub-sets to platinum-based chemotherapy are the poorly differentiated carcinomas involving the mediastinal-retroperitoneal nodes, the peritoneal papillary serous adenocarcinomatosis in females and the poorly differentiated neuroendocrine carcinomas.
  • Other tumours successfully managed by locoregional treatment with surgery and/or irradiation are the metastatic adenocarcinoma of isolated axillary nodes, metastatic squamous cell carcinoma of cervical nodes, or any other single metastatic site.
  • Empirical chemotherapy benefits some of the patients who do not fit into any favourable sub-set, and should be considered in patients with a good performance status.
  • [MeSH-major] Neoplasms, Unknown Primary / diagnosis. Neoplasms, Unknown Primary / therapy

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  • [CommentIn] Eur J Cancer. 2004 Jun;40(9):1454-5 [15177507.001]
  • (PMID = 12957453.001).
  • [ISSN] 0959-8049
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 119
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22. Nieder C, Ang KK: Cervical lymph node metastases from occult squamous cell carcinoma. Curr Treat Options Oncol; 2002 Feb;3(1):33-40
MedlinePlus Health Information. consumer health - Head and Neck Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cervical lymph node metastases from occult squamous cell carcinoma.
  • Depending on patient and tumor characteristics, reported 5-year actuarial survival rates of patients with cervical nodal metastasis from an unknown primary carcinoma range from 18% to 63%.
  • Retrospective studies suggest that neck relapse is more common than are distant metastases or emergence of mucosal primary tumors.
  • The treatment options include neck dissection alone, radiation alone to the neck with or without the putative mucosal origin, and combination unilateral neck dissection plus limited or comprehensive radiotherapy.
  • Also, the confounding effects of patient selection for various treatment modalities on therapeutic outcome cannot be quantified.
  • A randomized trial to compare the therapeutic value of comprehensive versus volume-limited radiotherapy is being planned.
  • No data were found to support the benefit of chemotherapy for the treatment of this disease.
  • [MeSH-major] Carcinoma, Squamous Cell. Head and Neck Neoplasms. Lymphatic Metastasis. Neoplasms, Unknown Primary

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  • (PMID = 12057085.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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23. Matsubara N, Mukai H, Nagai S, Itoh K: Review of primary unknown cancer: cases referred to the National Cancer Center Hospital East. Int J Clin Oncol; 2010 Dec;15(6):578-82

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Review of primary unknown cancer: cases referred to the National Cancer Center Hospital East.
  • BACKGROUND: Primary unknown cancer (PUC) is not rare neoplasm.
  • The clinical features and survival time of these patients are heterogeneous.
  • In 41 patients (32.5%), primary malignancies were identified by immunohistochemical studies and radiographical workup after referral to our hospital.
  • About 50% of patients with unfavorable subsets received chemotherapy.
  • CONCLUSION: In about half of the patients with preliminary diagnosed PUC, the primary origin could be identified, or it was possible to distinguish subsets with favorable prognosis.
  • [MeSH-major] Adenocarcinoma / secondary. Carcinoma, Squamous Cell / secondary. Neoplasms, Unknown Primary / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cancer Care Facilities. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Japan. Lymphatic Metastasis. Male. Medical Records. Middle Aged. Neoplasm Staging. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 20700615.001).
  • [ISSN] 1437-7772
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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24. Ligey A, Gentil J, Créhange G, Montbarbon X, Pommier P, Peignaux K, Truc G, Maingon P: Impact of target volumes and radiation technique on loco-regional control and survival for patients with unilateral cervical lymph node metastases from an unknown primary. Radiother Oncol; 2009 Dec;93(3):483-7
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  • [Title] Impact of target volumes and radiation technique on loco-regional control and survival for patients with unilateral cervical lymph node metastases from an unknown primary.
  • PURPOSE: To compare the impact of an unilateral post-operative irradiation or a bilateral irradiation in terms of loco-regional control and survival in patients with cervical lymph node of squamous cell carcinoma from an unknown primary (CUP).
  • METHODS AND MATERIALS: Ninety five patients with epidermoid carcinoma involving unilateral cervical lymph nodes from an unknown primary were treated in two institutions from 1990 to 2007.
  • Post-operative radiation therapy was delivered to one side of the neck in 59 cases, to both sides of the neck in 36 cases.
  • The occult primary occurred in 12% after unilateral irradiation and 6% after bilateral radiotherapy.
  • There was no difference in loco-regional control (p=0.639) and no difference in survival (p=0.493) when chemotherapy was associated.
  • [MeSH-major] Carcinoma, Squamous Cell / radiotherapy. Lymphatic Metastasis / radiotherapy. Neck. Neoplasms, Unknown Primary
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Head and Neck Neoplasms / diagnosis. Head and Neck Neoplasms / mortality. Humans. Male. Middle Aged. Neck Dissection. Neoplasm Recurrence, Local. Radiotherapy Dosage. Radiotherapy, Conformal. Radiotherapy, Intensity-Modulated. Sentinel Lymph Node Biopsy. Survival Rate

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  • (PMID = 19892420.001).
  • [ISSN] 1879-0887
  • [Journal-full-title] Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
  • [ISO-abbreviation] Radiother Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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25. Khouchani M, Benchakroun N, Tahri A, Tawfiq N, Jouhadi H, Acharki A, Sahraoui S, Belaabidia B, Benider A: [Breast metastasis from vulvar carcinoma: case report and review of literature]. Cancer Radiother; 2008 Mar;12(2):120-5
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  • [Title] [Breast metastasis from vulvar carcinoma: case report and review of literature].
  • The breast metastases resulting of vulvar carcinoma are very rare, and represent exceptionally the first manifestation of the disease.
  • We report the case of a 42 year-old patient who underwent a treatment because of vulvar epidermoid carcinoma, right away metastatic at the level of the inguinal ganglia.
  • The treatment consisted in a total vulvectomy with bilateral ganglial curretage, followed by external radiotherapy about the perineum and the inguinal ganglia.
  • Three months after the end of her treatment, the patient presented with a nodula on the left outer breast with features of malignancy noticed by clinic and mammographic examination.
  • The histologic study of the mammary biopsy showed epidermoid carcinoma of likely metastatic origin.
  • A left Patey has been realized and confirmed the metastatic localization of epidermoid carcinoma with axillary ganglial metastasis (2N+/-7).
  • Besides, this patient presented a right cervical ganglial parcel that the biopsy showed a metastatic localization of a vulvar carcinoma.
  • A palliative chemotherapy type cyclophosphamid, adriblastin, cisplatine (CAP) has been admistrated during three cycles spaced out three weeks.
  • The clinicians must remember this possible tropism of the vulvar cancer for the breast, not only during the supervision and the complete examination as regards the disease spreading but also when the affection revealed unknown primary tumor.
  • In this stage, the treatment is unfortunately palliative, the survival until a year is not more than 20%.
  • [MeSH-major] Breast Neoplasms / secondary. Carcinoma, Squamous Cell / secondary. Vulvar Neoplasms / pathology

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  • (PMID = 18343704.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 31
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26. Dietl B, Marienhagen J, Schaefer C, Pohl F, Kölbl O: [Frequency and distribution pattern of distant metastases in patients with ENT tumors and their consequences for pretherapeutic staging]. Strahlenther Onkol; 2007 Mar;183(3):138-43
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  • [Transliterated title] Häufigkeit und Topographie von Fernmetastasen bei Patienten mit HNO-Tumoren und ihre onsequenzen für das prätherapeutische Staging.
  • PATIENTS AND METHODS: 600 patients (526 men, 76 women, median age 56 years) with ENT tumors (squamous cell carcinoma histology) were studied retrospectively.
  • The distribution of primary tumor site and stage (AJCC) was as follows: oropharynx: n = 161 (26.8%), hypopharynx: n = 187 (31.2%), oral cavity: n = 89 (14.8%), larynx: n = 118 (19.7%), cancer of unknown origin: n = 13 (2.2%), others: n = 32(5.3%), I: n = 24 (4%), II: n = 49 (8.2%), III: n = 89 (14.8%), IV: n = 438 (73%).
  • The following parameters were analyzed in association with distant metastases: tumor localization, T- and N-category, primary treatment, local tumor control, and second neoplasms.
  • RESULTS: 114/600 patients (19%) developed distant metastases, 29/600 (4.9%) at presentation, 50% within 9.3 months after diagnosis of the primary tumor.
  • Distant metastases were most frequent in stage IV (24.2%), carcinoma of the hypopharynx (25.7%), local recurrence (24.3%), and second neoplasm (31.7%) with the following distribution pattern: pulmonary 61/114 (53.5%), pleural 15/114 (13.1%), osseous 45/114 (39.5%), hepatic 14/114 (12.3%), cerebral 8/114 (7%), cutaneous 14/114 (12.3%).
  • CONCLUSION: With locally advanced ENT tumor stage IVa/b, carcinoma of the hypopharynx, local recurrence or second neoplasms, at least a pretherapeutic CT of the thorax should be performed because every seventh patient (88/600) developed metastases or second primary tumors within the thoracic space during the course of disease.
  • Regarding the side effects and costs of curative therapy, the definition of generally accepted guidelines for the systemic staging of locally advanced ENT tumors should be undertaken.
  • [MeSH-major] Carcinoma, Squamous Cell / secondary. Otorhinolaryngologic Neoplasms / pathology
  • [MeSH-minor] Carcinoma, Bronchogenic / pathology. Carcinoma, Bronchogenic / secondary. Combined Modality Therapy. Disease Progression. Female. Humans. Lung Neoplasms / pathology. Lung Neoplasms / secondary. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Metastasis / pathology. Neoplasm Staging. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Multiple Primary / pathology. Neoplasms, Multiple Primary / radiotherapy. Neoplasms, Multiple Primary / surgery. Neoplasms, Second Primary / pathology. Positron-Emission Tomography. Retrospective Studies. Tomography, X-Ray Computed

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  • (PMID = 17340072.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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27. Busby JE, Brown GA, Tamboli P, Kamat AM, Dinney CP, Grossman HB, Matin SF: Upper urinary tract tumors with nontransitional histology: a single-center experience. Urology; 2006 Mar;67(3):518-23
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  • OBJECTIVES: To review our experience with patients with upper urinary tract tumors of nonurothelial origin.
  • Upper urinary tract tumors of nonurothelial origin are uncommon entities.
  • Anderson Cancer Center from 1990 to 2004 to identify patients with primary nonurothelial tumors of the upper urinary tract.
  • We reviewed the patient records to collect data on tumor subtype, treatment, recurrence, and survival.
  • RESULTS: Sixteen patients (1.9% of our database of patients with upper urinary tract tumors) were identified; 12 had squamous cell carcinoma, 2 had adenocarcinoma, 1 had sarcomatoid carcinoma, and 1 had small cell carcinoma.
  • Of the 16 patients, 15 had been treated with nephrectomy or nephrouterectomy and 1 with chemotherapy and radiotherapy.
  • Ten patients received adjuvant chemotherapy.
  • Of the 16 patients, 9 died (1 of unknown causes), 4 were alive without disease, 2 were alive with disease, and 1 was alive at last follow-up with the disease status unknown.
  • The median follow-up was 30.1 months, the median overall survival time was 11.3 months, and 1-year survival rate was 46%.
  • The median recurrence-free survival time and 1-year recurrence-free survival rate were 5.8 months and 38%, respectively.
  • CONCLUSIONS: Primary nonurothelial carcinomas of the renal pelvis and ureter are rare.
  • Our analysis suggests a poor prognosis for most patients with these pathologic types, probably resulting from the advanced stage at diagnosis and poor responses to systemic therapy.
  • [MeSH-major] Carcinoma / pathology. Kidney Neoplasms / pathology. Kidney Pelvis. Ureteral Neoplasms / pathology

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  • (PMID = 16527570.001).
  • [ISSN] 1527-9995
  • [Journal-full-title] Urology
  • [ISO-abbreviation] Urology
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA79449; United States / NCI NIH HHS / CA / CA91846
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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28. Lassman AB, Abrey LE, Shah GD, Panageas KS, Begemann M, Malkin MG, Raizer JJ: Systemic high-dose intravenous methotrexate for central nervous system metastases. J Neurooncol; 2006 Jul;78(3):255-60
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  • BACKGROUND: Treatment options for patients with recurrent central nervous system (CNS) metastases are limited.
  • Twenty-nine patients had breast cancer, and one each had cancer of unknown primary (CUP), squamous cell carcinoma of the head and neck, and non-small cell lung cancer (NSCLC).
  • Prior treatment with low-dose MTX for systemic disease did not affect response (P = 0.8).
  • CONCLUSIONS: HD IV MTX is effective in the treatment of CNS metastases with disease control (response or stable) as a best response in 56% of assessable patients.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / secondary. Methotrexate / administration & dosage
  • [MeSH-minor] Adult. Aged. Breast Neoplasms / drug therapy. Breast Neoplasms / mortality. Breast Neoplasms / pathology. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / mortality. Carcinoma, Non-Small-Cell Lung / pathology. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / pathology. Dose-Response Relationship, Drug. Female. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / mortality. Head and Neck Neoplasms / pathology. Humans. Infusions, Intravenous. Lung Neoplasms / drug therapy. Lung Neoplasms / mortality. Lung Neoplasms / pathology. Male. Middle Aged. Neoplasms, Unknown Primary / drug therapy. Neoplasms, Unknown Primary / mortality. Neoplasms, Unknown Primary / pathology. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • [ErratumIn] J Neurooncol. 2006 Jul;78(3):261. Shah, Gaurav G [corrected to Shah, Gaurav D]
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  • (PMID = 16344918.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA009512
  • [Publication-type] Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; YL5FZ2Y5U1 / Methotrexate
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