Diagnosis and Management of Squamous Cell Carcinoma of Unknown Primary in the Head and Neck

Publication Date: April 23, 2020

Key Points

Key Points

Management decisions for squamous cell carcinoma of unknown primary (SCCUP) are best decided in the context of a multidisciplinary tumor board and with careful consideration of human papillomavirus (HPV) status, disease burden and distribution in the neck, a patient’s overall health and well-being, potential treatment-related toxicity, and rehabilitation potential for functional recovery.

Preoperative Evaluation

...Preoperative...

...ients undergoing evaluation for a neck mas...


...dle aspiration or core biopsy of a clinically sus...


...k human papillomavirus (HR-HPV) testing sho...


...Contrast enhanced computed tomography (CECT...


...mary is not evident on clinical examinatio...


Diagnostic And Therapeutic Surgical Procedures

...Diagnostic And T...

...: Patients should undergo a complete operativ...


...ts with unilateral lymphadenopathy, if a pri...


...For patients with bilateral lympha...


2.4: For patients in whom the primary tu...


...issue specimens from suspected primary...


...ative frozen section of biopsies of suspicious...


Surgical Considerations

...Surgical C...

...small-volume bilateral neck diseas...


...volume bilateral neck disease, and/or gross (ma...


...ry surgery is planned, Levels IIA, III...


...lateral, small-volume neck disease, e...


Radiotherapy

...Radiotherapy...

...Patients receiving radiotherapy or concurre...


...treated with primary radiotherapy for unilateral...


...s treated with primary radiotherapy...


...s presenting with clinical scenarios highly sugg...


...: In patients with a clinicopathologic...


...ts treated with primary radiotherap...


...addition to anatomic mucosal regions at...


...Patients treated with primary radiothe...


...atients treated with primary radiotherapy,...


...Patients receiving radiotherapy or co...


...nts for whom no primary site is pathologically ide...


...2: Adjuvant radiotherapy should not be adm...


...nt radiotherapy should be administered...


...4: Adjuvant radiation dose to the d...


Systemic Therapy

...Systemic...

...Concurrent administration of cisplatin w...


...oncurrent administration of cisplatin with def...


...administration of cisplatin to adjuvant ra...


...Concurrent administration of cisplatin with d...


Figure 1. Diagnosis & Management Algorithm of SCCUP in the Head and Neck

...agnosis & Management Algorithm of SCCUP...

Figure 2. Diagnosis & Management Algorithm of SCCUP in the Head and Neck (continued)

...Diagnosis & Management Algorithm of SCCUP in...