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

...rative Evaluation...

...nts undergoing evaluation for a neck...


...Fine-Needle aspiration or core biopsy of a cl...


...High-risk human papillomavirus (HR-HPV) te...


...trast enhanced computed tomography (CECT) of the n...


...ary is not evident on clinical examination and...


Diagnostic And Therapeutic Surgical Procedures

...iagnostic And Therapeutic Surgical Procedure...

...should undergo a complete operative upper aerodi...


...r patients with unilateral lymphadenopa...


...atients with bilateral lymphadenopathy, if...


...ents in whom the primary tumor is ide...


...: Tissue specimens from suspected prim...


...raoperative frozen section of biopsies of...


Surgical Considerations

...l Considerations...

...olume bilateral neck disease with no clini...


...ge-volume bilateral neck disease, a...


...y surgery is planned, Levels IIA, III and I...


...teral, small-volume neck disease, either...


Radiotherapy

...diotherapy...

...ients receiving radiotherapy or concurre...


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


...treated with primary radiotherapy for unilate...


...n patients presenting with clinica...


...atients with a clinicopathologic presentation...


...ents treated with primary radiotherapy fo...


...on to anatomic mucosal regions at risk, patients t...


...Patients treated with primary radiotherapy for N3...


...r patients treated with primary radiotherapy, a bi...


...nts receiving radiotherapy or concu...


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


...: Adjuvant radiotherapy should not be adminis...


4.13: Adjuvant radiotherapy should be administer...


...radiation dose to the dissected regions of...


Systemic Therapy

...ystemic Therap...

...administration of cisplatin with defini...


...: Concurrent administration of cisplatin wi...


...ncurrent administration of cisplatin to...


...nt administration of cisplatin with definitive ra...


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

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

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

...gure 2. Diagnosis & Management Algorith...