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

...reoperative Evalu...

...Patients undergoing evaluation for a neck mass...


...ine-Needle aspiration or core biopsy o...


...High-risk human papillomavirus (HR-HPV) testing sh...


...trast enhanced computed tomography...


...a primary is not evident on clinical examination a...


Diagnostic And Therapeutic Surgical Procedures

...tic And Therapeutic Surgical Pro...

...tients should undergo a complete operative...


...s with unilateral lymphadenopathy,...


...or patients with bilateral lymphadenopathy, if a...


...atients in whom the primary tumor is identified du...


...ssue specimens from suspected primary sites (bio...


...6: Intraoperative frozen section of b...


Surgical Considerations

...gical Considerations...

...l-volume bilateral neck disease with no clinical e...


...Large-volume bilateral neck disea...


...primary surgery is planned, Levels...


....1: For unilateral, small-volume n...


Radiotherapy

...adiotherapy

...receiving radiotherapy or concurrent chemoradi...


...treated with primary radiotherapy fo...


...ients treated with primary radioth...


....4: In patients presenting with clin...


...tients with a clinicopathologic presentatio...


...treated with primary radiotherapy for un...


...In addition to anatomic mucosal regions...


...8: Patients treated with primary radiothera...


...r patients treated with primary radiothera...


...Patients receiving radiotherapy or...


...ts for whom no primary site is pathologi...


...uvant radiotherapy should not be administer...


...radiotherapy should be administered to pat...


...juvant radiation dose to the disse...


Systemic Therapy

...emic Therap...

...ent administration of cisplatin with definitive...


...current administration of cisplatin with definit...


4.17: Concurrent administration of cispla...


...rrent administration of cisplatin w...


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

...1. Diagnosis & Management Algorithm of SCC...

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

...igure 2. Diagnosis & Management Algorithm...