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Management of Unknown Primary Cancer of the Head and Neck

  • Jennifer Christenson
  • Ryan J. LiEmail author
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Head and neck cancer with an unknown primary site (CUP) often presents as an asymptomatic, enlarging neck mass, which is then confirmed to represent metastatic nodal disease. These cancers are encountered with increasing frequency in many head and neck surgical oncology practices. The majority of CUP occurs in patients over age 40 years, and is most frequently suspected as having an oropharyngeal primary site, and a causal association with high-risk human papillomavirus infection. The majority of patients diagnosed with CUP on initial presentation, will have a detectable primary tumor after thorough diagnostic evaluation, either within the tongue base or palatine tonsil. A comprehensive diagnostic evaluation and understanding of the advantages and disadvantages of treatment options is essential to serve patients with the best oncologic outcomes and least morbidity possible. In this chapter, we review contemporary research advancing the evaluation and management of CUP. As head and neck squamous cell carcinoma is the most commonly encountered histopathology of CUP, the majority of this chapter focuses on this form of cancer.

Keywords

Unknown primary Head and neck cancer Human papillomavirus Oropharyngeal cancer Tonsil cancer Tongue base cancer Transoral cancer surgery 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Head and Neck SurgeryOrlando Health UF Health Cancer CenterOrlandoUSA
  2. 2.Department of Otolaryngology—Head and Neck SurgeryOregon Health & Science UniversityPortlandUSA

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