Cancer of unknown primary origin overview: Difference between revisions
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== Pathophysiology == | == Pathophysiology == | ||
The exact [[pathogenesis]] of cancer of unknown primary origin is not fully understood. | The exact [[pathogenesis]] of cancer of unknown primary origin is not fully understood. Several studies noted consistency between metastatic cancer of unknown primary and metastases with known primary origins based on chromosomal abnormalities and overexpression of several genes. | ||
==Causes== | ==Causes== | ||
Several studies have evaluated the [[Chromosomal anomalies|chromosomal]] and molecular anomalies found in cancers of unknown primary; however, they could not identify unique causes of metastasis of unknown primaries relative to those with known primary origins. | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Cancer of unknown primary is a diagnosis of exclusion; hence, all other differentials in addition to primary tumor location must be ruled out prior to [[Diagnosis WikiDoc|diagnosis]]. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
The prevalence of cancer of unknown primary origin is approximately 10 cases per 100,000 individuals worldwide. Patients of all age groups may develop cancer of unknown primary origin. In most cases cancer of unknown primary origin affects men and women equally. There is no racial predilection to cancer of unknown primary origin. | |||
==Risk Factors== | ==Risk Factors== | ||
There are no established risk factors specific for cancer of unknown primary origin. | |||
==Screening== | ==Screening== | ||
There is insufficient evidence to recommend routine screening for cancer of unknown primary origin. | |||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
Early clinical features include fatigue, weight-loss, and loss of appetite. Common [[complications]] of cancer of unknown primary origin, may include: [[hypercalcemia]], [[adrenal insufficiency]], and [[Siadh|inappropriate antidiuretic syndrome]], [[Hematologic diseases|hematologic disorders]], and malignant effusions. Prognosis is generally poor, and the average survival time of patients with cancer of unknown primary origin is approximately 6-12 months after diagnosis. | |||
== | == Diagnosis == | ||
Revision as of 03:39, 12 February 2019
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Cancer of unknown primary origin Microchapters |
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Differentiating Cancer of Unknown Primary Origin from other Diseases |
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Cancer of unknown primary origin overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: ; Roukoz A. Karam, M.D.[2]
Overview
Cancer of unknown primary origin or CUP is the diagnosis of metastatic cancer when the anatomic site of origin remains unidentified. Cancer of unknown primary origin is common, and it accounts for 2–5% of all cancers. Cancer of unknown primary origin may be classified according to pathology findings into 4 groups: adenocarcinomas, poorly differentiated carcinomas, squamous cell carcinomas, and carcinomas with neuroendocrine differentiation. The majority of patients with cancer of unknown primary origin may be initially asymptomatic. Early clinical features include fatigue, weight-loss, and loss of appetite. If left untreated, the majority of patients with cancer of unknown primary origin may progress to develop multiple organ failure, heart failure, and death. The treatment for cancer of unknown primary origin will depend on several factors, such as: metastatic origin, biopsy findings, patients age, and performance status. The 5-year survival of patients with cancer of unknown primary origin is less than 2%.
Historical Perspective
Cancer of unknown primary origin was first discovered in the 1980s and was based solely on imaging studies.
Classification
Cancer of unknown primary origin may be classified based on light microscopy of the tissue biopsy into 4 groups including adenocarcinomas, squamous cell carcinomas, poorly differentiated tumors, and carcinomas with neuroendocrine differentiation.
Pathophysiology
The exact pathogenesis of cancer of unknown primary origin is not fully understood. Several studies noted consistency between metastatic cancer of unknown primary and metastases with known primary origins based on chromosomal abnormalities and overexpression of several genes.
Causes
Several studies have evaluated the chromosomal and molecular anomalies found in cancers of unknown primary; however, they could not identify unique causes of metastasis of unknown primaries relative to those with known primary origins.
Differential Diagnosis
Cancer of unknown primary is a diagnosis of exclusion; hence, all other differentials in addition to primary tumor location must be ruled out prior to diagnosis.
Epidemiology and Demographics
The prevalence of cancer of unknown primary origin is approximately 10 cases per 100,000 individuals worldwide. Patients of all age groups may develop cancer of unknown primary origin. In most cases cancer of unknown primary origin affects men and women equally. There is no racial predilection to cancer of unknown primary origin.
Risk Factors
There are no established risk factors specific for cancer of unknown primary origin.
Screening
There is insufficient evidence to recommend routine screening for cancer of unknown primary origin.
Natural History, Complications, and Prognosis
Early clinical features include fatigue, weight-loss, and loss of appetite. Common complications of cancer of unknown primary origin, may include: hypercalcemia, adrenal insufficiency, and inappropriate antidiuretic syndrome, hematologic disorders, and malignant effusions. Prognosis is generally poor, and the average survival time of patients with cancer of unknown primary origin is approximately 6-12 months after diagnosis.