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Review
. 2021 Nov;30(6):e13459.
doi: 10.1111/ecc.13459. Epub 2021 May 1.

Diagnostic approaches to carcinoma of unknown primary of the head and neck

Wenda Ye  1 , Ethan H Arnaud  1 , Alexander Langerman  1 , Kyle Mannion  1 , Michael C Topf  1
Affiliations
Review

Diagnostic approaches to carcinoma of unknown primary of the head and neck

Wenda Ye et al. Eur J Cancer Care (Engl). 2021 Nov.

Abstract

Squamous cell carcinoma in cervical lymph nodes arising from an undetected primary tumour, termed carcinoma of unknown primary (SCCUP), is a well-recognized clinical presentation within head and neck oncology. SCCUP is a common presentation for patients with human papillomavirus-mediated oropharyngeal cancer (HPV + OPSCC), as patients with HPV + OPSCC often present with smaller primary tumours and early nodal metastasis. Meticulous work-up of the SCCUP patient is central to the management of these patients as identification of the primary site improves overall survival and allows for definitive oncologic resection or more focused radiation when indicated. This review summarizes the comprehensive diagnostic approach to the SCCUP patient, including history and physical examination, methods of biopsy of the cervical lymph node, imaging modalities and intraoperative methods to localize the unknown primary. Novel techniques such as transcervical ultrasound of the oropharynx, narrow band imaging and diagnostic transoral robotic surgery are also discussed.

Keywords: carcinoma of unknown primary; head and neck cancer; oropharyngeal cancer; robotic surgery.

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References

REFERENCES

    1. Addams-Williams, J., Watkins, D., Owen, S., Williams, N., & Fielder, C. (2009). Non-thyroid neck lumps: Appraisal of the role of fine needle aspiration cytology. European Archives of Oto-Rhino-Laryngology, 266, 411-415.
    1. Alam, K., Khan, R., Jain, A., Maheshwari, V., Agrawal, S., Chana, R. S., & Harris, S. H. (2009). The value of fine-needle aspiration cytology in the evaluation of pediatric head and neck tumors. International Journal of Pediatric Otorhinolaryngology, 73, 923-927.
    1. Al-Mulki, K., Hamilton, J., Kaka, A. S., Boyce, B. J., Baddour, H. M., El-Deiry, M., Solares, C. A., Magliocca, K., Summers, K., Aiken, A., Saba, N. F., Beitler, J. J., & Patel, M. R. (2020). Narrowband imaging for p16+ unknown primary squamous cell carcinoma prior to transoral robotic surgery. Otolaryngology - Head and Neck Surgery, 163, 1198-1201.
    1. Barbosa, M., Duarte, H., Breda, E., & Monteiro, E. (2013). PET/CT in the management of metastatic cervical lymphadenopathy from unknown primary site: A seven years retrospective study. Revue de Laryngologie - Otologie - Rhinologie, 134, 89-94.
    1. Blanco, R. G., Califano, J., Messing, B., Richmon, J., Liu, J., Quon, H., Neuner, G., Saunders, J., Ha, P. K., Sheth, S., Gillison, M., & Fakhry, C. (2014). Transcervical ultrasonography is feasible to visualize and evaluate base of tongue cancers. PLoS One, 9, e87565.

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