Differences of Methods of Searching Primary Site of Carcinoma Unknown Primary between Traditional and Standard Guideline

Background: Trends of searching primary has been changed as etiological backup are changing. PET- CT and other viral molecular markers has been included in most recent protocols for searching primary of carcinoma unknown primary (CUP). Despite of the exhaustive effort with traditional tool many unknown primaries are not known. Patients with CUP without localizing primary, are subjected to radical surgery, wide-field radiation and chemotherapy during treatment. Objectives: To determine the effectiveness of localization of the primary tumor by using conventional technique and to compare the outcome of it to the standard guideline. Methods:This was a prospective study. In conventional search, after thorough clinical examination and diagnostic workup, Panendoscopy with bilateral Tonsillectomy and excision of tongue base mucosa in selective cases is done. Biopsy from nasopharynx, Larynx and hypopharynx is done only when clinically suspected. PET-CT and other viral/molecular markers has been done for recent standard protocol group. Results: In conventional method, Out of 29 patient, 6 primaries found. 5 in tonsil and 1 in base of the tongue base. In standard protocol method, out of 34 cases with PET-CT and viral marker 8 primaries detected, 5 in tonsil and 2 in tongue base and 1 in nasopharynx. Conclusion: Unknown head and neck primaries present a diagnostic challenge that outcome in the search of primary for CUP may be improved by digital examination and appropriate tissue examination in traditional detection protocols. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 142-146

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Detection of Occult Primary Tumors in Patients with Cervical Metastases of Unknown Primary Tumors: Comparison of18F FDG PET/CT with Contrast-enhanced CT or CT/MR Imaging—Prospective Study

Radiology ◽

10.1148/radiol.14141073 ◽

2015 ◽

Vol 274 (3) ◽

pp. 764-771 ◽

Cited By ~ 53

Author(s):

Jae Ryung Lee ◽

Jae Seung Kim ◽

Jong-Lyel Roh ◽

Jeong Hyun Lee ◽

Jung Hwan Baek ◽

...

Keyword(s):

Mr Imaging ◽

Prospective Study ◽

Unknown Primary ◽

Primary Tumors ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Pet Ct ◽

Enhanced Ct ◽

Fdg Pet Ct ◽

Unknown Primary Tumors

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Performance of 18F-FDG-PET/CT as a next step in the search of occult primary tumors for patients with head and neck squamous cell carcinoma of unknown primary: a systematic review and meta-analysis

Clinical and Translational Imaging ◽

10.1007/s40336-021-00429-w ◽

2021 ◽

Author(s):

Huo Huasong ◽

Shen Shurui ◽

Gao Shi ◽

Ji Bin

Keyword(s):

Systematic Review ◽

Squamous Cell Carcinoma ◽

Fdg Pet ◽

Meta Analysis ◽

Unknown Primary ◽

Primary Tumors ◽

Carcinoma Of Unknown Primary ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Tongue base mucosectomy for carcinoma of unknown primary using endoscopic electrocautery: rationale for wider implementation of an institutionally restricted technique

The Journal of Laryngology & Otology ◽

10.1017/s0022215118002062 ◽

2018 ◽

Vol 132 (12) ◽

pp. 1138-1142 ◽

Cited By ~ 1

Author(s):

C R Davies-Husband

Keyword(s):

Primary Tumour ◽

Intensity Modulated Radiotherapy ◽

Cervical Squamous Cell Carcinoma ◽

Primary Site ◽

Tongue Base ◽

Unknown Primary ◽

Unknown Primary Site ◽

Cervical Metastasis ◽

Positron Emission ◽

Negative Findings

AbstractBackgroundCervical metastasis from an unknown primary site invariably results in pan-mucosal irradiation if a primary tumour is not identified. Transoral robotic and laser-assisted mucosectomy are valid techniques to increase diagnostic rates, but these remain restricted to certain centres. This paper describes, in detail, a technique in which mucosectomy is performed via endoscopic electrocautery.MethodsPatients were prospectively recruited between May 2017 and June 2018. Inclusion criteria stipulated biopsy-proven metastatic cervical squamous cell carcinoma, with negative findings on magnetic resonance imaging and positron emission tomography/computed tomography, in addition to examination under anaesthetic, tonsillectomy and ‘blind’ tongue base biopsies without tumour identification, prior to mucosectomy.ResultsOf nine patients, a mucosal primary was identified in four (44.4 per cent), for which ipsilateral intensity-modulated radiotherapy was advocated in three and completion tongue base resection in the fourth. Dysplasia was demonstrated in two further patients, which provided information relevant to radiotherapy fields and post-treatment surveillance. No surgical complications were identified.ConclusionTongue base mucosectomy using electrocautery and conventional tonsillectomy equipment is a safe, effective technique in the identification of cervical metastasis from an unknown primary site. It expands the potential breadth of use, quickens prolonged diagnostic pathways and obviates the necessity for pan-mucosal irradiation.

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EVALUATING THE ROLE OF FDG PET-CT SCAN AS A SOLE IMAGING MODALITY IN THE MANAGEMENT OF MUO NECK

10.36106/ijsr/3930114 ◽

2020 ◽

pp. 39-41

Author(s):

Krishnappa Krishnappa ◽

Krishna Prasad ◽

Shruti Satish ◽

Murali R Nadig

Keyword(s):

Ct Scan ◽

Predictive Value ◽

Fdg Pet ◽

Imaging Modality ◽

False Negative ◽

Unknown Primary ◽

Pet Ct ◽

Fdg Pet Ct ◽

Pet Ct Scan

Aim:to study the role of PET- CT SCAN as a single imaging modality in the diagnosis of MUO neck. methodology: retrospective study analysis of 51 cases of clinical unknown primary with cervical metastasis . RESULTS: FDG PET CT tracer uptake was detected in 24/51. true positive in 18 cases out of 24,false positive in 6 cases, false negative in 2 cases with sensitivity of 90%, specificity of 82%,positive predictive value of 75%,negative predictive value of 93% and accuracy of 84.91%. conclusion: FDG PET CT can be used as a sole imaging modality in the diagnosis of MUO neck.it is complimentary to endoscopy.

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