Cervical Malignant Tumors of Unknown Primary Origin; From View of Roentgen Diagnosis

Abstract

From 1987 through 1994, 337 patients with malignant tumors visited our department; 147 of them had a cervical masses, which could have been diagnosed as a metasis from an unknown primary tumor. In order to determine the usefulness of roentgenologic diagnosis, we investigated the process by which the primary tumor was confirmed.
The diagnosis was malignant lymphoma in 43 of the 147 cases. In 80 were the primary origin was determined by anamnesis and local examinations, and in 19 by diagnostic imaging. Two other patients were diagnosed as branchial cancer by postoperative histological examination. Finally, three patients were shown to have metastatic cancer from an unknown primary tumor.
In diagnostic imaging, the usefulness of CT was confirmed, but MRI also gave helpful information in two patients with epipharyngeal cancer, two of the cancer of base of the tongue, and one with thyroid gland cancer.
The three cervical metastatic cancers from an unknown primary site were all in males, and their cervical lesions were presented in the suprahyoid area; the histology was squamous cell carcinoma.
We investigated the role of MRI in the serch for the primary site of metastatic cervical tumor. It has been assumed that the percentage of cancers of unknown primary origin is decreasing, since MRI and CT can find primary lesions of cervical metastases, but there was no definite decrease in this study. If oral floor cancer could be proved by histological examination in the first patient with cancer from unknown origin in this study, the percentage of cancers of unknown primary origin might be reduced.