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Results for “Neoplasms, Unknown Primary”

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At least 19 recordsLinked to original sources
PubMed1978

Factors leading to delay in the diagnosis and affecting survival of children with head and neck rhabdomyosarcoma.

Rhabdomyosarcoma of the head and neck often presents with vague symptoms which mimic other disease conditions. These factors lead to undue delay in the establishment of the correct diagnosis and the delivery of acceptable therapy, including surgery, radiation therapy, and chemotherapy. There is, however, evidence of improved results of treatment of these tumors since the addition of multiple drug chemotherapy to surgery and radiotherapy.

Adolescent↗
PubMed2026

Genetic mutations in metastatic adenocarcinoma of unknown primary.

INTRODUCTION: Although several genomic alterations have been reported in adenocarcinoma of unknown primary (ACUP), molecularly targeted therapies are not yet clinically established, and comprehensive genomic profiling (CGP) is rarely used in daily practice. AIM: We aimed to clarify the molecular landscape and prognostic impact of key mutations in recurrent or metastatic ACUP. MATERIALS AND METHODS: Data from 480 consecutive ACUP patients registered in Japan's National Cancer Center (C-CAT) between June 2019 and August 2025 were analyzed. Somatic mutations were identified using the FoundationOne CDx platform. Overall survival (OS) was assessed by Kaplan-Meier analysis, log-rank tests, and multivariate Cox proportional hazards modeling. RESULTS: The most frequent alterations were TP53 (59.4%), KRAS (31.5%), CDKN2A (26.3%), KMT2D (22.3%), LTK (17.9%), NOTCH3 (16.9%), STK11 (16.3%), CDKN2B (15.8%), ERBB2 (15.4%), and GNAS (15.2%). Patients harbored an average of 17.3 9.9 mutations. Mutations in GNAS (p = 0.046) and PIK3CA (p = 0.025) were associated with better OS, whereas ARID1A (p = 0.049) and NOTCH1 (p = 0.038) predicted worse OS. In Cox analysis, hazard ratios (HR [95% CI]) were 0.57 (0.36-0.92, p = 0.020) for GNAS, 0.57 (0.33-0.96, p = 0.033) for PIK3CA, 1.98 (1.27-3.09, p = 0.0024) for ARID1A, and 1.84 (1.17-2.91, p = 0.0090) for NOTCH1. CONCLUSIONS: GNAS and PIK3CA mutations were linked to favorable outcomes, while ARID1A and NOTCH1 alterations indicated poor prognosis in ACUP. These results highlight the prognostic significance of specific genomic alterations and support integrating CGP into the clinical management of ACUP.

Humans↗
PubMed2026

Accuracy of frozen section for HPV-Associated squamous cell carcinoma of unknown primary.

INTRODUCTION: Current guidelines for the management of metastatic squamous cell carcinoma of unknown primary (SCCUP) recommend submission of suspicious primary sites for frozen section analysis (FSA). This study aims to investigate the diagnostic accuracy of FSA for identification of HPV-associated SCCUP. METHODS: A retrospective cohort study of patients with biopsy-proven p16-positive SCCUP who underwent diagnostic operation at two tertiary care institutions was performed. Sensitivity, specificity, PPV, and NPV of diagnostic FSA were assessed. RESULTS: 77 patients were included in analysis. 66 patients underwent definitive TORS (diagnostic TORS operation with subsequent neck dissection after identification of the occult primary tumor), 7 patients underwent diagnostic TORS (TORS to identify occult primary tumor, no neck dissection), and 4 patients underwent direct laryngoscopy and biopsy only. Primary tumors were identified in 63 patients (82%) with a mean tumor size of 1.1 cm. There was no significant difference in size between patients whose tumor was identified on FSA (mean 1.1 cm) and on permanent only (mean 0.9 cm) (p = 0.26). The sensitivity, specificity, PPV, and NPV of FSA for SCCUP was 86%, 100%, 100%, and 86%, respectively. Diagnostic frozen specimens included 52 direct laryngoscopy biopsies and 69 TORS excisions. In the biopsies, sensitivity was 100% and NPV was 100%, whereas in the TORS-excised specimens, sensitivity was 77% and NPV was 77%. CONCLUSIONS: In this case series of 77 patients with SCCUP, the sensitivity and NPV of FSA for identification of the primary tumor was over 85%. FSA is valuable during diagnostic operation for SCCUP.

Humans↗
PubMed1978

Primary orbital hemangiopericytoma. An aggressive and potentially malignant neoplasm.

The aggressive behavior and potentially lethal nature of some hemangiopericytomas primary in the orbit are generally unknown in the field of ophthalmology. The neoplasm is not common in the orbit, and reports in the ophthalmic literature usually describe single-case examples of the neoplasm with short-term periods of observation. Two in our series of 11 patients died of metastasis 35 years after the onset of symptoms. Another patient died of local orbital recurrence with secondary invasion of the intracranial vault, which was possibly related to heavy radiotherapy. In the orbit, those neoplasms frequently are circumscribed in their growth. Complete and intact removal is recommended. If the tumors are incompletely excised, recurrences are frequent but may not be manifest as long as ten years after surgery.

Adult↗
PubMed1979

Computed tomography of calcified liver metastases.

The computed tomography findings of six patients with calcified liver metastases are presented. The significance of this finding in patients with unknown primary malignancies or after multiple courses of chemotherapy is stressed.

Adult↗
PubMed1976

Cell-mediated immunity to mouse tumors: some recent findings.

Lymphocyte mediated immune reactions play a major role in the immunological defense against antigenic tumor cells. Serum factors (antigens, antigen-antibody complexes) can thwart these reactions, perhaps by interfering with a lymphocyte "activation" process. Blocking factors can be eluted from lymphoid cells harvested from tumor-bearing animals. One way of increasing cell-mediated reactivity to tumor antigens appears to be to sensitize (or "activate") lymphocytes against tumor antigens in vitro. Another way may be to inoculate animals with sera containing lymphocyte-dependent and unblocking antibodies. Preliminary evidence is presented that inoculation of such sera from rabbits immunized with mouse embryonie cells and extensively absorbed may delay the appearance of primary, methyleholanthrene-induced sarcomas in BALB/c mice; the mechanisms responsible for this delay remain unknown.

Animals↗
PubMed1977

Estrogen receptor assay in the differential diagnosis of adenocarcinomas.

Estrogen receptor determination by the sucrose gradient method was applied to 295 tumor tissues of various origins. Estrogen receptor of the 8 S type was found only in adenocarcinoma of the breast, uterus, and ovary. Of 19 patients with metastatic carcinoma of unknown origin, four benefited from estrogen receptor study (ie, appropriate therapy could be initiated) and one was helped retrospectively on the clinical diagnosis. Estrogen receptor assays may also be useful in determining whether bilateral breast involvement represents two primary lesions or metastasis. Estrogen receptor studies should be included in evaluating cancers of unknown origin in female patients.

Adenocarcinoma↗
PubMed1978

Malignant neoplasms of the paranasal sinuses involving the skin.

Malignant neoplasms of the mucosa and minor salivary glands of the paranasal sinuses may involve the skin by direct extension. When a tumor appears on the overlying skin, these sinuses should be considered as a possible site of origin. Adenoid cystic carcinoma of the paranasal sinuses arise from minor salivary glands. They can infiltrate overlying skin and easily be confused with a primary cutaneous adenoid cystic carcinoma. Malignant melanomas of the paranasal sinuses are clinically very aggressive. They are often amelanotic, and this may lead to an incorrect histopathologic diagnosis. Hence, physical and radiological examination of the nose, mouth, and paranasal sinuses should be performed whenever a tumor appears in the overlying skin that does not have a clear cutaneous origin or whenever the primary site of a metastatic malignant melanoma is unknown.

Aged↗
PubMed1978

Osteoblastic bone metastases secondary to adenocarcinoma of the pancreas.

The incidence of bone metastases secondary to adenocarcinoma of the exocrine pancreas is unknown since radiological studies of the bones during life, routine bone scintigrams or extensive examination of the skeleton at autopsy is rarely undertaken in the absence of specific clinical indications. Symptom-producing bone metastases are relatively uncommon; a review of the literature suggests that the vast majority are osteolytic in nature with only a few isolated case reports of purely blastic deposits. In the authors' experience osteoblastic bone metastases are commoner than is generally recognised. Of 12 patients with symptom-producing bone deposits secondary to adenocarcinoma of the pancreas, five (41.6%) were purely blastic in nature. The clinical, radiological and pathological findings in these five cases are reported in order to emphasise that the pancreas is a potential source of purely blastic bone metastases and should be considered as a possible primary site in patients who present initially with osteoblastic bone deposits of unknown origin.

Adenocarcinoma↗
PubMed1978

An immunologic basis for detection of occult primary malignancies of the head and neck.

After extensive evaluation of patients with metastatic neck disease and clinically undetectable primary cancer of the head and neck, the clinician is often faced with the difficult question of subsequent management. In this study, sera from 11 patients with clinically occult carcinoma and metastatic lymphadenopathy were studied for Epstein-Barr virus-associated antigens. These were compared with 35 sera from patients with known nasopharyngeal carcinoma at all stages of disease and treatment and with 212 sera from control patients with other head and neck tumors, patients with lymphoma, and normal controls. There was a significant correlation between high antibody titers to Epstein-Barr virus, especially in the serum IgA fraction, and the presence of nasopharyngeal carcinoma. Thus, identification of occult nasopharyngeal carcinoma by immunologic means may have important application in the selective management of the patient with an unknown head and neck primary malignancy.

Antibodies, Viral↗
PubMed1977

Incidence of bone metastases in women with minimal and occult breast carcinoma.

A total of 42 women with proved minimal (14) or occult (28) breast carcinoma were evaluated for up to 48 months (mean = 28 months). Bone scans, radiographs, blood chemistries, enzyme levels, and operative findings demonstrated metastases only in those 6 patients (14%) who presented with symptomatic metastases from an unknown primary source. The other 36 women are free of metastases. Preoperative radionuclide bone scans may not be necessary for women with minimal and asymptomatic occult breast cancers.

Bone Neoplasms↗