Occult Primary with Cervical Secondary-Role of CT Scan and Evaluation Under Anesthesia

  • Ila B. UpadhyaEmail author
  • Jay Suratwala
Original Article


The potential of CT, MRI or both to detect a primary tumor ranges from 9.3 to 23% rising to 60% when suspicious radiological findings direct subsequent endoscopic biopsies (Zhuang et al. in Mol Clin Oncol 2:917–922, 2014). Prospective case Study. To know the sensitivity, specificity accuracy rate and P value of CT scan and upper aero digestive tract endoscopy with palpation of nasopharynx and oropharynx to search the primary site of cancer. 53 patient of occult primary with FNAC proved metastatic squamous cell carcinoma were evaluated to find out the sensitivity, specificity, accuracy rate and P value of imaging study and rigid endoscopic examination of upper aero digestive tract with through palpation of oropharynx, nasopharynx and evaluation under anesthesia (EUA). Punch biopsies were taken from suspicious areas and sent for histopathology examination (HPE). Taking HPE as a gold standard (Ishak et al in Rawal Med J 35:209–213, 2010) sensitivity of both EUA and imaging was found to be 100%, Specificity and diagnostic accuracy of EUA and imaging were 96.77, 83.87, 98.11 and 90.57% respectively. P value was <0.0000001 which is highly significant.


Occult Unknown Primary Cervical Cancer Metastasis Endoscopy 



Indirect laryngoscopy


Computerized tomography


Fine needle aspiration cytology


Outpatient department


Evaluation under anesthesia


Fine needle aspiration cytology


Metastatic cervical carcinoma from an unknown primary


Carcinoma of unknown origin


Squamous cell carcinoma


Head and neck


Magnetic resonance imaging


Compliance with Ethical Standards

Conflict of interest

Dr Ila Upadhya the corresponding author and Dr Jay Suratwala, declare that we do not have any conflict of interest.


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Copyright information

© Association of Otolaryngologists of India 2017

Authors and Affiliations

  1. 1.Department of ENTGovernment Medical CollegeMajuragate, SuratIndia
  2. 2.SuratIndia
  3. 3.SuratIndia

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