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. 2022 Apr:93:106954.
doi: 10.1016/j.ijscr.2022.106954. Epub 2022 Mar 16.

Comprehensive evaluation on cancer of unknown primary site and how we managed it: A case report

Erwin Danil Yulian  1 , Lie Rebecca Yen Hwei  2 , Renaningtyas Tambun  3 , Alvita Dewi Siswoyo  4 , Maria Fransisca Ham  5 , Indrati Suroyo  4
Affiliations

Comprehensive evaluation on cancer of unknown primary site and how we managed it: A case report

Erwin Danil Yulian et al. Int J Surg Case Rep. 2022 Apr.

Abstract

Introduction and importance: Cancer of unknown primary site (CUP) is metastatic cancer without primary tumor found from comprehensive medical history, physical examination, and regular laboratory examination. Eighty percent of CUP include unfavorable groups with 3 to 6 months of median survival despite chemotherapy treatment.

Case presentation: A 52-year-old male was presented with a chief complaint of a recurrent lump in the neck and axilla. After comprehensive examinations over three years, the primary site of the metastatic tumor could not be found. Therefore, this patient was diagnosed with cancer of an unknown primary site.

Clinical discussion: In patient with CUP, more precise therapy can only begin when the exact form of cancer is identified. However, the delay in diagnosis would worsen the patient's condition, as treatment measures cannot be implemented.

Conclusion: Trimodal modalities including surgery, chemotherapy, and radiotherapy are suitable for CUP with squamous cell carcinoma proven in immunohistochemistry evaluation.

Keywords: Axilla dissection; Cancer of unknown primary site; Metastatic cancer; Radical neck dissection; Squamous cell carcinoma; Trimodal modalities.

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Conflict of interest statement

The authors declare that there is no conflict of interest in this case report.

Figures

Fig. 1
Fig. 1
PET Scan showing uptake on the right tonsil and multiple lymphadenopathies.
Fig. 2
Fig. 2
Intraoperative view and tissues were taken from the bilateral neck dissection.
Fig. 3
Fig. 3
The results of pathology examination on tissues taken from bilateral neck dissection. (A) Lymph node containing syncytial solid tumor metastases with pleomorphic, spindle, vesicular, hyperchromatic, nucleoli, and eosinophilic cytoplasm on 40× magnification. (B) Solid syncytial tumor cell with a pleomorphic nucleus, spindle, vesicular, hyperchromatic, nucleoli, clear eosinophilic cytoplasm, and mitosis found on 400× magnification.
Fig. 4
Fig. 4
Ultrasonography examination showed multiple lymphadenopathies.
Fig. 5
Fig. 5
Axial chest CT scan showed right axilla lymphadenopathy without any other pathological lesion, nodule, or opacity in the lungs.
Fig. 6
Fig. 6
Nasopharynx CT scan showed there was a hard mass in the right intraocular.
See this image and copyright information in PMC

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