Diagnosis of Metastatic Squamous Neck Cancer with Occult Primary

Diagnosis of Metastatic Squamous Neck Cancer with Occult Primary

Tests will include checking for a primary tumor in the organs and tissues of the respiratory tract, the upper part of the digestive tract (including the lips, mouth, tongue, nose, throat, vocal cords, and parts of the esophagus and trachea), and the genitourinary system. The following procedures may be used:
  • Physical exam and history: An exam of the body, especially the head and neck, to check general signs of health. This includes checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through an incision (cut) in the skin or opening in the body, such as the mouth or nose. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease. The larynx, pharynx, esophagus, trachea, and bronchi will be checked.
  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist or tested in the laboratory to check for signs of cancer. Two types of biopsy may be done:
    • Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
    • Excisional biopsy: The removal of an entire lump of tissue.
  • Sinus x-ray: An x-ray of the sinuses (hollow spaces in the head). An x-ray is a type of energy beam that can go through the body onto film, making pictures of areas inside the body. A biopsy may be taken.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Serum tumor marker test: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs, tissues, or tumor cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the blood. These are called tumor markers. The test will be done to detect the following tumor markers:
    • Alpha-fetoprotein (AFP).
    • Beta-human chorionic gonadotropin (β-hCG).
A diagnosis of occult primary tumor is made if the primary tumor is not found during testing or treatment. Factors Affecting Prognosis and Treatment Options: The prognosis (chance of recovery) and treatment options depend on the following:
  • The number and size of lymph nodes that have cancer in them.
  • Whether the cancer has responded to treatment or has recurred (come back).
  • How different from normal the cancer cells look under a microscope.
  • The patient’s age and general health.
Treatment options also depend on the following:
  • Which part of the neck the cancer is in.
  • Whether certain tumor markers are found.
  Stages The process used to find out if cancer has spread to other parts of the body is called staging. There is no standard staging process for metastatic squamous neck cancer with occult primary. The tumors are described as untreated or recurrent. Untreated metastatic squamous neck cancer with occult primary is cancer that is newly diagnosed and has not been treated, except to relieve symptoms caused by the cancer. The following tests and procedures may be used to find out if the cancer has spread to other parts of the body, such as the lung or liver:
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Cancer spreads in the body through blood, tissue or the lymph system. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. Recurrent Metastatic Squamous Neck Cancer with Occult Primary Recurrent metastatic squamous neck cancer with occult primary is cancer that has recurred (come back) after it has been treated. The cancer may come back in the neck or other parts of the body.