Diagnosis and treatment of patients with metastases of squamous cell carcinoma unknout primary site

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Abstract

The term “metastases of a malignant tumor with an unidentified primary site (from an unknown primary site)” refers to a malignant disease presented by metastatic tumors in which the primary site can be identified based on neither the patient’s clinical history nor diagnostic evaluation. This malignancy is characterized by an unknown anatomical origin of the primary tumor at the time treatment is initiated. Metastatic squamous cell carcinoma of unknown primary sites for 5 % of all head and neck malignancies.

This pathology is frequently confused with benign tumors, especially at an early stage of development. Prior to referral to a specialized hospital, most patients with this type of cancer received treatment for other diseases, so the time for early initiation of therapy following the identification of the primary site was lost. A thorough examination of cervical lymph nodes with suspected neoplasia is necessary for the timely diagnosis of the malignancy and identification of the primary site. Histological types of the tumor include squamous cell carcinoma, adenocarcinoma, neuroendocrine carcinoma, and anaplastic carcinoma. An association of the tumor with wart virus or Epstein–Barr virus is sometimes noted, which determines the treatment strategy.

The article presents a diagnostic algorithm for metastatic squamous cell carcinoma of unknown primary site based on data from the N. N. Blokhin National Medical Research Center of Oncology obtained in 2014–2024, including clinical, imaging, and pathomorphological findings, as well as treatment options for this pathology.

About the authors

Konstantin A. Zolotarev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); S. S. Yudin City Clinical Hospital, Moscow Healthcare Department

Author for correspondence.
Email: zolotarev31@mail.ru
ORCID iD: 0000-0002-9015-7030

Institute of Clinical Medicine named after N. V. Sklifosovskiy, Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Oncology Center No. 1 – branch of S. S. Yudin City Clinical Hospital, Moscow Healthcare Department

Russian Federation, 24 Kashirskoe Shosse, Moscow 115522; Bld. 2, 11 Rossolimo St., Moscow119021; Bld. 7, 18A Zagorodnoye Shosse, 117152 Moscow

A. M. Mudunov

Clinical Hospital “Lapino” of the “Mother and Child” Group of companies; Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: zolotarev31@mail.ru
ORCID iD: 0000-0002-0918-3857
Russian Federation, 111 1st Uspenskoe Shosse, Lapino, Moscow Region 143081; Bld. 2, 8 Trubetskaya St., Moscow 119048

Yu. V. Alymov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: zolotarev31@mail.ru
ORCID iD: 0000-0002-6851-9867
Russian Federation, 24 Kashirskoe Shosse, Moscow 115522

O. A. Saprina

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Email: zolotarev31@mail.ru
ORCID iD: 0000-0002-2283-1812
Russian Federation, 24 Kashirskoe Shosse, Moscow 115522

N. N. Tatintsyan

RUDN Universtiy

Email: zolotarev31@mail.ru
ORCID iD: 0009-0007-7905-2522
Russian Federation, 6 Miklukho-Maklaya St., Moscow 117198

A. R. Gizzatullin

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: zolotarev31@mail.ru
ORCID iD: 0009-0005-2544-2459
Russian Federation, 1 Ostrovityanova St., Moscow 117513

V. M. Eroshina

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: zolotarev31@mail.ru
ORCID iD: 0009-0006-3584-9188
Russian Federation, 1 Ostrovityanova St., Moscow 117513

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