title: [A case of primary unknown cancer responding to CDGP/S-1].
abstract: A 77-year-old woman visited our hospital with the chief complaint of left supraclavicular lymph node redness and swelling. Needle biopsy revealed metastatic, epithelial, undifferentiated carcinoma. However, the primary tumor remained unknown despite further thorough examinations, FDG-PET showed abnormal FDG accumulation at the lymph nodes of para-aortic and left external iliac artery area in addition to left supraclavicular lymph node. However, CT and MRI showed no lymph node swelling in the peritoneal cavity. Nedaplatin (CDGP) combined with S-1 therapy was carried out for this primary unknown cancer with lymph node metastases. Three months after CDGP/S-1 therapy was begun, the swollen left supraclavicular lymph node was obviously reduced by 42.5%. Moreover, abnormal FDG accumulation at left supraclavicular and para-aortic lymph nodes dramatically decreased and that at the left external iliac artery area disappeared. The anti-tumor effect was evaluated as a partial response by use of Response Evaluation Criteria in Solid Tumors (RECIST). Standard treatment for primary unknown cancer was not established, because it includes various carcinomas. Here we report a case of primary unknown cancer successfully treated with CDGP/S-1. This combined therapy was considered to be one of the promising strategies for a primary unknown cancer.
authors.affiliation: Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Jun
authors.initials: J
authors.lastname: Kamiyama
authors.forename: Hirosumi
authors.initials: H
authors.lastname: Itoi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Oyamada
authors.forename: Mari
authors.initials: M
authors.lastname: Hirose
authors.forename: Shoko
authors.initials: S
authors.lastname: Goto
authors.forename: Natsuko
authors.initials: N
authors.lastname: Hatanaka
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Taiyoh
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsumura
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D001706:Biopsy; D004338:Drug Combinations; D005260:Female; D006801:Humans; D009382:Neoplasms, Unknown Primary / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D010094:Oxonic Acid / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D005641:Tegafur / Q000627:therapeutic use*; D014463:Ultrasonography
chemical_list: D004338:Drug Combinations; D009944:Organoplatinum Compounds; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; C053989:nedaplatin