Head & Neck
Carcinoma of Unknown Primary (CUP)
Carcinoma of unknown primary (CUP) refers to a type of cancer where malignant cells are found in the body, typically in metastatic form, but the primary site or origin of the cancer cannot be identified despite extensive diagnostic efforts. This means that after thorough investigations including imaging tests, biopsies, and laboratory analyses, the specific organ or tissue where the cancer originated remains unknown. CUP presents as cancer that has already spread to other parts of the body such as lymph nodes, bones, liver, lungs, before the primary tumour is identified. The metastases are often discovered first through imaging studies or clinical symptoms.
Diagnosis
Diagnosing CUP is challenging because the primary tumour site may be small, spontaneously regressed, or asymptomatic. The absence of a primary tumour can complicate treatment decisions because different types of cancer respond differently to therapies. The identification process involves a comprehensive evaluation, including imaging tests (CT scan, MRI, PET scan) to locate tumours, biopsies of metastatic sites to confirm the presence of cancer cells, and extensive pathological examination to try to determine the tissue type and possible origin.
Treatment
Treatment for CUP depends on factors such as the extent of spread, the histology of the cancer cells, and the patient’s overall health. It often involves a multidisciplinary approach with oncologists, pathologists, and radiologists. Treatment may include surgery, radiation therapy, chemotherapy, targeted therapies, or a combination of these, aiming to control the disease and alleviate symptoms.
