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Carcinoma of Unknown Primary

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Clinical PET and PET/CT

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Abstract

Carcinoma of unknown primary (CUP) represents the group of heterogeneous tumors, which can be defined as the presence of histologically proven metastatic disease and unidentified site of origin at the time of diagnosis in spite of comprehensive diagnostic workup (Pavlidis, Acta Oncol 46:592–601, 2007). CUP tumors are not infrequently encountered in oncologic practice. The incidence of CUP tumors in oncologic patients is 0.5–7% at the time of the initial diagnosis (Abbruzzese et al. J Clin Oncol 12:1272–80, 1994; Daugaard, Cancer Treat Rev 20:119–47, 1994) and its prevalence is between 3% and 15% (Abbruzzese et al. J Clin Oncol 13:2094–103, 1995). Frequent first settings for the metastatic lesions are lymph nodes (37%); of these, 31% are located in the head and neck region, which is the most common site for metastases of unknown origin (Lefebvre et al. Am J Surg 160:443–6, 1990; Scheidhauer et al. PET in clinical oncology, 2000, pp. 169–76). CUP tumors present metastatic dissemination patterns that are different from those observed in oncologic conditions with known primary tumors: (1) Short symptomatic prediagnostic interval exists before the clinical presentation; (2) CUP tumor becomes symptomatic at the time of metastatic disseminations; (3) the most frequent primary sites in patients with CUP tumors do not include the several most common primary tumors in the general population; (4) no specific metastatic location has been consistently associated with a specific primary tumor site (Leinard and Nystrom, Semin Oncol 20:244–50, 1993). These aspects make it difficult to locate the primary tumor, which is one of the most important factors for establishing the most effective treatment (Delgado-Bolton et al. J Nucl Med 44:1301–14, 2003).

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Authors and Affiliations

  1. Molecular Imaging Research Center, Korea Institute of Radiological and Medical Sciences (KIRAMS), Department of Nuclear Medicine, Korea Cancer Center Hospital, Nowon-gu, Seoul, 139-706, South Korea

    Gi-Jeong Cheon M.D.

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  1. Gi-Jeong Cheon M.D.
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Correspondence to Gi-Jeong Cheon M.D. .

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Editors and Affiliations

  1. and Diagnostic Radiology, The University of Texas, Departments of Nuclear Medicine, Holcombe Blvd. 1515, Houston, 77030, Texas, USA

    E. Edmund Kim

  2. Gachon University School of Medicine, Department of Nuclear Medicine, Guwol-dong 1198, Namdong-Gu, Incheon, 405, Korea, Republic of (South Korea)

    Myung-Chul Lee

  3. Yokohama City University, Graduate School of Medicine, Department of Radiology, Fukuura 3-9, Yokohama, Kanagawa, 236-0004, Japan

    Tomio Inoue

  4. The University of Texas, MD Anderson Cancer Center, Dept. of Experimental Diagnostic Imaging, Holcombe Blvd. 1400, Houston, 77030, Texas, USA

    Wai-Hoi Wong

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Cheon, GJ. (2013). Carcinoma of Unknown Primary. In: Kim, E., Lee, MC., Inoue, T., Wong, WH. (eds) Clinical PET and PET/CT. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0802-5_29

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  • DOI: https://doi.org/10.1007/978-1-4419-0802-5_29

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