2016, Number 1
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Otorrinolaringología 2016; 61 (1)
Cervical lymph node metastases of squamous cell carcinoma from unknown primary. Current diagnostic and therapeutic approach
Gallegos-Hernández JF
Language: Spanish
References: 20
Page: 57-65
PDF size: 464.97 Kb.
ABSTRACT
When lymph node metastases are identified in the neck, but the clinical,
imaging and endoscopy evaluation does not identify the primary tumor, diagnosis of metastases with unknown primary is established; in this
entity most patients have tumor confined to the supraclavicular area,
so it is unnecessary to carry out systematic search. Most metastases are
squamous cell carcinoma, the most common tumor originated in head
and neck mucosa. The lack of a primary tumor requires treatment not
only of the neck, but also of the sites where the primary tumor could
arise and of contralateral neck, but the morbidity that this treatment
produces makes questionable the need to do it routinely. The vast majority
of patients with a primary unknown cannot be treated with a single
therapeutic modality and must be submitted to surgery, radiotherapy or
concomitant chemo-radiotherapy, the key to the therapeutic decision is
the proper staging. The modulated intensity radiation therapy, and the
value of human papillomavirus and Epstein-Barr virus in the etiology
of head and neck cancer have changed the therapeutic approach to
this entity in last years. The aim of this paper is to provide readers with
current diagnostic and therapeutic approach of this neoplasm.
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