Cancer of unknown primary site (CUP) is an intriguing clinical phenomenon seen in 3-9% of all Head and neck cancers. Neck node metastasis seen around 5-10% of all patients with CUP. Metastasis in upper and middle neck occurs from head and neck cancers. Where as metastasis to lower neck is associated with cancers below the clavicles like thyroid cancer, lung cancer, colon cancer and ovarian cancer. Diagnostic set up consist clinical evaluation, panendoscopy of upper aerodigestive tract, CT & MRI imaging, Biopsies (FNAB, open biopsy), molecular assay from all suspicious site. The optimal therapeutic management of patient with cervical CUP remains controversial due to absence of randomized studies comparing different treatment options. However NCCN has given a established guidelines for management of CUP. The major authors recommend surgical removal of neck disease, followed by post-operative radiotherapy alone or radio-chemotherapy.
Unknown primary, Panendoscopy, Metastasis.