Publication details
METASTÁZY KARCINOMŮ V KRČNÍCH UZLINÁCH S NEZNÁMÝM PRIMÁRNÍM TUMOREM
| Title in English | Neck metastases from unknown primary carcinoma |
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| Authors | |
| Year of publication | 2016 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Neck lymph node metastases from occult primary constitute about 2-9% of all patients with carcinoma of unknown primary site. Metastases in the upper and middle neck (levels I-II-III-V) are generally attributed to head and neck cancers, whereas the lower neck (level IV) involvement is often associated with primaries below the clavicles. Diagnostic procedures include a careful clinical evaluation and a fiberoptic endoscopic examination of the head and neck mucosa, biopsies from all suspicious sites or blindly from the sites of possible origin of the primary, computerized tomography scan or magnetic resonance. The most frequent histological finding is squamous cell carcinoma. In these cases, a systematic tonsillectomy in the absence of suspicious lesions is adviced since up to 25% of primary tumours can be detected in this site. Thoracic, and abdominal primaries (especially from lung, oesophagus, stomach, ovary or pancreas) should be sought in the case of adenocarcinoma and involvement of the lower neck. Positron emission tomography with fluoro-2-deoxy-D-glucose allows detection of primary tumour in about 25% of cases. Therapeutic approaches include surgery (neck dissection), with or without post-operative radiotherapy, radiotherapy alone and radiotherapy followed by surgery as reported by several guide-lines. |