Occult primary head and neck carcinoma

Cecelia E. Schmalbach, Frank R Miller

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Unknown primary carcinoma presenting as cervical lymph node metastasis accounts for approximately 5% of all head and neck malignancies. The typical presentation involves a middle-aged man with a painless neck mass that has been present for several months. Over 90% of these malignancies represent squamous cell carcinoma originating within Waldeyer's ring (lymphoid tissue of the nasopharynx, tonsil, and base of tongue). The remainder are comprised of adenocarcinoma, melanoma, and other rare histologic variants. The ability to identify the occult primary tumor is imperative because identification allows site-specific therapy and avoidance of wide-field radiation side effects. Following confirmation of metastatic cervical disease with fine-needle aspiration, all patients presenting with an unknown primary carcinoma require a thorough head and neck history and physical examination, radiographic imaging, panendoscopy with directed biopsies of Waldeyer's ring, and bilateral tonsillectomy. Positron emission tomography has proved helpful in identifying occult primary tumors of the head and neck region.

Original languageEnglish (US)
Pages (from-to)139-146
Number of pages8
JournalCurrent Oncology Reports
Volume9
Issue number2
DOIs
StatePublished - Mar 2007

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Neck
Head
Carcinoma
Neoplasms
Tonsillectomy
Nasopharynx
Palatine Tonsil
Radiation Effects
Lymphoid Tissue
Fine Needle Biopsy
Tongue
Positron-Emission Tomography
Physical Examination
Squamous Cell Carcinoma
Melanoma
Adenocarcinoma
Lymph Nodes
History
Neoplasm Metastasis
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Occult primary head and neck carcinoma. / Schmalbach, Cecelia E.; Miller, Frank R.

In: Current Oncology Reports, Vol. 9, No. 2, 03.2007, p. 139-146.

Research output: Contribution to journalArticle

Schmalbach, Cecelia E. ; Miller, Frank R. / Occult primary head and neck carcinoma. In: Current Oncology Reports. 2007 ; Vol. 9, No. 2. pp. 139-146.
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