Patients presenting with metastatic disease in the neck from an occult primary tumor remain a diagnostic and therapeutic challenge. However, many patients presenting with squamous cell carcinoma, especially those with early stage disease, may be offered effective treatment with the prospect of a favorable outcome. It is essential that a thorough evaluation be undertaken before definitive therapy. Careful physical examination, imaging studies, and endoscopy with biopsies will detect the primary tumor in 90% of patients presenting with a node in the neck. The outcome for patients with advanced disease may be improving with the advent of hyperfractionated radiation and concurrent chemotherapy.


Donegan—CHAPTER 61

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Assessment and Management of the Unknown Primary with Neck Disease

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