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Chapter-076 Unknown Primary Tumor

BOOK TITLE: Head & Neck Surgery (2 Volumes)

Author
1. Lal Devyani
2. Hong Robert S
3. Petruzzelli Guy J
ISBN
9788184486797
DOI
10.5005/jp/books/10351_76
Edition
1/e
Publishing Year
2009
Pages
21
Author Affiliations
1. Mayo College, Mayo Clinic, Phoenix, Arizona, Loyola University Health System Illinois, USA, Mayo Clinic, Phoenix, Arizona, USA
2. Michigan Ear Institute; Wayne State University, Farmington Hills, Michigan, USA
3. Loyola University Medical Center, Illinois, USA, Cardinal Bernardin Cancer Center, Loyola University Health System, Illinois, USA, Curtis and Elizabeth Anderson Cancer Institute and Memorial University, Medical Center; Savannah, Georgia, USA
Chapter keywords
primary tumor, malignancy, lymph node, fine needle aspiration biopsy, cervical adenopathy, neck oncology, metastatic adenopathy

Abstract

This chapter discusses unknown primary tumor, where patients with histologically confirmed malignancy presenting in a lymph node without a clearly identified primary tumor are classified as having a carcinoma of an unknown primary (CUP) site or occult primary malignancy. The initial confirmation of malignancy should be made by fine needle aspiration biopsy thereby minimizing distortion and oncologic contamination of normal tissues should definitive resection be necessary. The diagnosis and management of patients with malignant cervical adenopathy lacking an obvious primary tumor remains one of the most challenging, yet potentially rewarding clinical scenarios in head and neck oncology. The severity of concurrent disease may have a significant impact on the patients’ overall survival in addition to potential choices for cancer treatment. Fine needle aspiration (FNA) is now a standard technique and should be included in the initial evaluation of all patients with suspected metastatic adenopathy.

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