![]() ![]() A diagnostic regimen that includes transoral surgery (TOS) of the base of the tongue (BOT) has demonstrated a diagnostic ability of approximately 90% of the primary cancers that otherwise would go undetected by contemporary diagnostic tools. The identification of the primary cancer can help better define the targeted areas for radiation therapy and provide more accurate staging and prognostic information for these patients. ![]() Patients who present with SCCHNUP can be treated with either surgery followed by adjuvant treatment or primary nonsurgical therapy. Since these patients provide a particularly challenging diagnostic problem to the head and neck surgeon, a systematic approach including a thorough physical examination, appropriate imaging, and surgical evaluation is necessary to identify the site of the primary cancer. However, as the incidence of human papillomavirus (HPV)–associated oropharyngeal cancer, which is known to metastasize to the lymph nodes with low-volume primary disease, continues to rise, SCCHNUP will likely increase in incidence as well. ![]() Retrospective studies suggest that SCCHNUP is a relatively rare disease, affecting between 1% and 3% of new cases of SSCHN. Patients with isolated supraclavicular metastatic carcinoma usually have a primary source from the skin or infraclavicular sites of origin (stomach, breast, lung, esophagus, and ovary) and are thus not the focus of this chapter. Metastatic carcinoma in the neck without an identifiable primary cancer is defined as a squamous cell carcinoma of the head and neck of unknown primary origin (SCCHNUP). Many patients with squamous cell carcinoma of the head and neck (SCCHN) present with metastasis to the cervical lymph nodes. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |