Cancer of Unknown Primary Site: Not All is Lost!
Muhammad Furrukh*, Ikram Burney, Asim Qureshi and Ritu Lakhtakia
Department of Oncology, Shifa International Hospital, Pakistan
- *Corresponding Author:
- Muhammad Furrukh
Department of Oncology
Shifa International Hospital
Tel: 0092 310 3335889
E-mail: [email protected]
Received Date: November 24, 2014; Accepted Date: December 19, 2014; Published Date: December 26, 2014
Citation: Furrukh M, Burney I, Qureshi A, Lakhtakia R (2015) Cancer of Unknown Primary Site: Not All is Lost!. J Clin Diagn Res 3:115. doi:10.4172/2376-0311.1000115
Copyright: ©2015 Furrukh M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A Cancer of Unknown Primary Site (CUPS) is defined as a metastatic tumor for which the site of origin remains unknown after establishing tissue diagnosis despite a standard diagnostic approach. It is still not known whether CUP is an entity with dormancy of primary as its hallmark or a distinct entity with specific genetic aberrations which define it as a primary metastatic disease. It poses a diagnostic challenge to the pathologists and often poses a therapeutic dilemma for the oncologists. The diagnostic algorithm includes; age, gender, histology, site of metastasis, distribution and natural history of disease, and expression of tissue specific markers by the malignant clones as revealed on immunostains, e.g. TTF1 for thyroid gland and adenocarcinoma lung, PSA for prostate gland, estrogen/ progesterone receptors and gross cystic disease fluid protein-15 for breast cancer, etc. Despite extensive and expensive diagnostic work up, in almost 20-45% cases the site of their origin remains unknown, however the yield rises to 70-80% after postmortem examination. While the pathology teams are working to resolve the primary site, the oncology teams are adamant on identifying subset of patients that may be treatable and potentially curable. However, CUPS remains aggressive, and generally associated with a poorer prognosis with a median survival of less than a year. The review focuses on current practices in diagnoses and treatment of an occasionally rare, and a challenging entity.