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  Patronage of the Polish Society of Audiology and Phoniatrics

vol 11. no 4. December 2012  

 Original articles
Diagnostic difficulties in determining the primary focus of the lymph node metastatic cancer
Zuzanna Pujanek, Paweł K. Burduk

Introduction. Cases of Carcinomas of Unknown Primary
syndrome (CUP-syndrome), though rare, are a major problem
in daily practice of ENT doctor. The detection of metastases
to cervical lymph nodes makes it necessary to find the primary
tumor, whereby it is possible to implement adequate, targeted
therapy and offer the patient a chance for survival.
Aim. Show the correct diagnostic procedure and compare
the effectiveness of primary tumor detection using currently
available modern imaging techniques.
Materials and methods. The paper presents three cases of
patients with CUP-syndrome, along with their history and the
process of searching for a primary focus.
Results. In the two cases presented by us, despite the meticulous
execution of a number of diagnostic and imaging procedures,
we have failed to determine the primary origin of cancer. In the
third patient with metastases to the cervical lymph node, cancer
came from the palatine tonsil. We discussed the problems
and treatment strategy of CUP-syndrome and compared the
available imaging methods and panendoscopy.
Conclusions. Detectability of the primary CUP-syndrome
continues to be low. Currently no imaging technique is
accessible to increase the effectiveness of this diagnosis.

keywords: CUP-syndrome, panendoskopia, leczenie

pages: from 179 to 179

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