Hidetoshi Tamura

Case of cervical carcinoma of unknown primary treated through multidisciplinary approach.

Carcinoma of unknown primary (CUP) is where the primary site remains unidentified even though metastases are present, and accounts for 3-5% of all human malignancies. Here, we report a multidisciplinary approach to the treatment of a squamous cell CUP occurring in the left cervical region. Following radical surgery for carcinoma of the colon, swelling occurred in the left cervical region in a 59-year-old man. The results of an incisional biopsy indicated a diagnosis of squamous cell carcinoma (SCC), and he was referred to our department for examination. The primary carcinoma was not identifiable despite an extensive diagnostic workup including a physical examination, fiberoptic endoscopy, computed tomography, magnetic resonance imaging, and fluorodeoxyglucose F18 positron emission tomography, resulting in a diagnosis of an SCC of unknown in the cervical region. The patient was initially treated with three cycles of docetaxel 75 mg/m(2)/day, cisplatin 100 mg/m(2)/day, and 5-fluorouracil 1,000 mg/m(2)/day as induction chemotherapy. This was followed by concurrent chemoradiotherapy (cisplatin 30 mg/m(2)/day, 70 Gy) and neck dissection. Subsequent pathological examination revealed no vestiges of the tumor. The patient has remained free from recurrence and metastasis for 6 years.