title: Carcinoma of unknown primary in the head and neck: The evaluation of the effectiveness of (18)F-FDG-PET/CT, own experience.
abstract: OBJECTIVE
  The aim of the present study was to estimate the clinical effectiveness of (18)F-FDG-PET/CT in the detection of the primary tumor in patients with histologically proven squamous cell carcinoma cervical lymph nodes metastasis from an unknown primary.
  
  
  BACKGROUND
  (18)F-fluorodeoxyglucose positron emission tomography combined with CT ((18)F-FDG-PET/CT) is believed to be very helpful in localization of primary tumor in CUP Syndrome patients.
  
  
  METHODS
  41 patients referred to Poznan Medical University Department of Head and Neck Surgery from January 2010 to December 2013 with CUP Syndrome were included in the study. All patients presented fine-needle biopsy proven squamous cell carcinoma metastasis of the upper-, or mid neck lymph nodes. The final results were obtained from the histopathologic reports of tissue samples from anatomical regions suspected for primary tumor, additional imaging exams as well as clinical follow-up data.
  
  
  RESULTS
  The (18)F-FDG-PET/CT successfully detected primary tumor in 7 out of 41 patients (17%). In two more cases the primary tumor was indicated in the lung. 24 of 41 patients (58.5%) analyzed in our study remained without evidence of a primary tumor. In 4 cases (9.75%) we did not reveal any pathology within the localizations indicated by PET/CT on panendoscopy. In 4 cases we obtained histological confirmation of neoplasm on panendoscopy despite the negative results of PET/CT examinations.
  
  
  CONCLUSIONS
  We may suppose a relatively high usefulness of (18)F-FDG-PET/CT in the diagnosis process of CUP Syndrome patients. High NPV may indicate patients with no symptoms of primary tumor, which allows to avoid extensive resection or extra imaging.
authors.affiliation: Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Majchrzak
authors.affiliation: Nuclear Medicine Department, Greater Poland Cancer Centre, Poznan, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Cholewiński
authors.affiliation: Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Golusiński
keywords: Carcinoma of unknown primary Syndrome; FDG-PET/CT; Squamous cell carcinoma