A2 Review article in a scientific journal
Unknown primary: diagnostic issues in the biological endoscopy and positron emission tomography scan era




List of Authors: Koivunen P, Back L, Laranne J, Irjala H
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Publication year: 2015
Journal: Current Opinion in Otolaryngology and Head and Neck Surgery
Journal name in source: CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY
Journal acronym: CURR OPIN OTOLARYNGO
Volume number: 23
Issue number: 2
Number of pages: 6
ISSN: 1068-9508

Abstract


Purpose of review: 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.



Recent findings: 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.



Summary: 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.




 



Last updated on 2019-21-08 at 20:01