Unknown primary: diagnostic issues in the biological endoscopy and positron emission tomography scan era

Current Opinion in Otolaryngology & Head and Neck Surgery
Petri KoivunenHeikki Irjala

Abstract

There is no general agreement on which diagnostic procedures are required and optimal in searching for primary tumors among patients with cervical metastasis of unknown primary (CUP). Because of the rising incidence of human papillomavirus (HPV)-associated oropharyngeal carcinoma, it is reasonable to assume that the number of small oropharyngeal tumors with neck metastasis will increase. The purpose of this review is to highlight the diagnostic approaches more useful in detecting such lesions. After the introduction of the narrow band imaging technique, positron emission tomography-computed tomography, and transoral diagnostic procedures, the accuracy in discovering the primary lesion is up to 80-90%. By far, most primaries arise in the oropharynx, especially among patients with p16/HPV-positive CUP. The oropharynx is the most likely primary site in patients with CUP, especially in p16/HPV-positive cases. By utilizing recent techniques, a high diagnostic accuracy in detecting the primary tumor is achievable; this may offer better survival rates with cost-effective efforts. We recommend some approaches for the diagnostic protocol used in searching for primary tumors in patients with CUP.

References

Jan 2, 1992·The New England Journal of Medicine·R FeinmesserH M Dosch
Nov 18, 1998·The Laryngoscope·S J McQuoneW M Koch
Oct 19, 2000·The Laryngoscope·C G Gourin, J T Johnson
Mar 10, 2001·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·W M KochD W Eisele
Nov 27, 2002·Seminars in Cancer Biology·K C Allen Chan, Y M Dennis Lo
Apr 10, 2003·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·Wolfgang J IssingStefan Tauber
Feb 5, 2008·The British Journal of Oral & Maxillofacial Surgery·Prasad KothariRoy Farrell
Aug 5, 2008·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·K C Allen ChanY M Dennis Lo
Jan 2, 2009·The Laryngoscope·Joshua D WaltonenAmit Agrawal
Oct 21, 2009·Archives of Otolaryngology--head & Neck Surgery·Joshua D WaltonenAmit Agrawal
Dec 24, 2009·Molecular Cancer·Emma V BarkerSuzanne Kamel-Reid
Aug 19, 2010·The Laryngoscope·Akihiro SakaiMasahiro Iida
Feb 19, 2011·Current Opinion in Otolaryngology & Head and Neck Surgery·Cesare PiazzaPiero Nicolai
Apr 16, 2011·The Laryngoscope·Ron J KarniBruce H Haughey
Aug 20, 2011·Head & Neck·Takeshi ShinozakiSatoshi Ebihara
Dec 22, 2011·Cancer Imaging : the Official Publication of the International Cancer Imaging Society·Robert Hermans
Oct 19, 2013·JAMA Otolaryngology-- Head & Neck Surgery·Sapna A PatelEduardo Méndez
Mar 13, 2014·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·J Kenneth ByrdUmamaheswar Duvvuri
May 9, 2014·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Kara S DavisUmamaheswar Duvvuri
Jun 6, 2014·Nuclear Medicine and Molecular Imaging·Soo Jin LeeDong Soo Lee
Aug 21, 2014·The New England Journal of Medicine·Gauri R Varadhachary, Martin N Raber

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Citations

Jun 17, 2016·Acta Oto-laryngologica·Lovisa FarneboAntti Mäkitie
Jul 19, 2018·Acta Oto-laryngologica·Katri AroLaura Tapiovaara
Oct 23, 2019·Seminars in Ultrasound, CT, and MR·Megan AlbertsonCraig Johnson
Feb 5, 2021·Chonnam Medical Journal·Kyeong Suk ParkSang Chul Lim

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Methods Mentioned

BETA
biopsies
biopsy
dissection
surgical resection

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