Carcinoma of Unknown Primary: A Case Report

Roslin Jose¹, Prerana Suresh Kurtkoti¹, Kavyamala¹, Sai Subramanyam K¹, Sunit Lokwani², Jayashankar CA^1, , Dyna Jones¹, Rohith N¹, Venkata Bharat Kumar Pinnelli³ and Venkata Ramana Kandi⁴

¹Department of General Medicine, Vydehi Institute of Medical Sciences and Research Centre, #82, EPIP Area, Nallurhalli, Whitefield, Bangalore – 560066, Karnataka

²Department of Medical Oncology, Vydehi Institute of Medical Sciences and Research Centre, #82, EPIP Area, Nallurhalli, Whitefield, Bangalore – 560066, Karnataka

³Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, #82, EPIP Area, Nallurhalli, Whitefield, Bangalore – 560066, Karnataka

⁴Department of Microbiology, Prathima Institute of Medical Sciences, Karimnagar, Telangana, India

Cite this paper:
Roslin Jose, Prerana Suresh Kurtkoti, Kavyamala, Sai Subramanyam K, Sunit Lokwani, Jayashankar CA, Dyna Jones, Rohith N, Venkata Bharat Kumar Pinnelli and Venkata Ramana Kandi. Carcinoma of Unknown Primary: A Case Report. American Journal of Cancer Prevention. 2018; 6(1):1-4. doi: 10.12691/ajcp-6-1-1

Abstract

Cancer of unknown primary (CUP), is a rare malignancy with unknown site of origin. The disease accounting for 2%-3% of all fatal malignancies, have variable histologic tumour types and clinical presentations. The present study discusses a case of CUP in a 68-year-old male subject, presenting with a 6-month history of abdominal pain in the upper abdomen. The patient was a chronic smoker and had the presence of bilateral testicular swelling for the past 15 years. The clinical examination of the patient revealed bilateral inguinal lymphadenopathy. The findings of the abdominal CT scan and the bone biopsy of the patient suggested metastatic carcinoma. 18F-fluorodeoxyglucose PET CT scan showed lytic lesions. The study recommends the need for a focused search, comprising of robust immunohistochemical profiling, for locating the primary tumors in CUP.

Keywords:
cancer of unknown primary (CUP) tumor malignancies metastatic carcinoma biopsy immunohistochemical profiling

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Briasoulis E, Tolis C, Bergh J, Pavlidis N. ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP). Ann Oncol 2005;16 Suppl 1: i75-6.
[2]	Rigakos G, Vakos A, Papadopoulos S, Vernadou A, Tsimpidakis A, Papachristou D, et al. Cancer of unknown primary ultimately diagnosed as male breast cancer: A rare case report. Mol Clin Oncol 2016; 5(2): 263-6.
[3]	Löffler H, Neben K, Krämer A. [Cancer of unknown primary. Epidemiology and pathogenesis]. Radiologe 2014;54(2): 107-11.
[4]	Rao A, Urban D, Mileshkin L, Bressel M, Lawrence YR. Cancer of unknown primary: a population-based analysis of temporal change and socioeconomic disparities. British Journal of Cancer 2013; 109(5): 1318.
[5]	Cancer of unknown primary incidence statistics [Internet]. Cancer Research UK. 2015 [cited 2017 Nov 28]. Available from: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cancer-of-unknown-primary/incidence.
[6]	Cancer Registration Statistics, England Statistical bulletins - Office for National Statistics [Internet]. [cited 2017 Nov 28]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/ cancerregistrationstatisticsengland/previousReleases.
[7]	Cancer | Publications | Health Topics | ISD Scotland [Internet]. [cited 2017 Nov 28]. Available from: http://www.isdscotland.org/Health-Topics/Cancer/Publications/.
[8]	Varadhachary GR, Greco FA. Overview of Patient Management and Future Directions in Unknown Primary Carcinoma. Semin Oncol 2009; 36(1): 75-80.
[9]	Carcinoma of Unknown Primary Treatment [Internet]. National Cancer Institute. [cited 2017 Nov 28]. Available from: https://www.cancer.gov/types/unknown-primary/patient/unknown-primary-treatment-pdq.
[10]	Greco FA, Hainsworth JD. Cancer of Unknown Primary Site. In: Oncology [Internet]. Springer, New York, NY; 2006 [cited 2017 Nov 28]. p. 1119-32.
[11]	Cancer risk statistics [Internet]. Cancer Research UK. 2015 [cited 2017 Nov 28]. Available from: http://www.cancerresearchuk.org/health-professional/cancer-statistics/risk.
[12]	Carretero RG, Brugera MR, Rebollo-Aparicio N, Mohamed LEB. Primary bone metastasis as first manifestation of an unknown primary tumour. BMJ Case Reports 2015; 2015: bcr2015211302.
[13]	Piccioli A, Maccauro G, Spinelli MS, Biagini R, Rossi B. Bone metastases of unknown origin: epidemiology and principles of management. J Orthop Traumatol 2015; 16(2): 81-6.
[14]	Briasoulis E, Pavlidis N. Cancer of Unknown Primary Origin. The Oncologist 1997; 2(3): 142-52.
[15]	Varadhachary GR. Carcinoma of Unknown Primary Origin. Gastrointest Cancer Res 2007; 1(6): 229-35.
[16]	Metastatic Cancer with Unknown Primary Site: Practice Essentials, Background, Pathophysiology. 2016 Oct 28; Available from: https://emedicine.medscape.com/article/280505-overview.
[17]	Pavlidis N, Fizazi K. Carcinoma of unknown primary (CUP). Crit Rev Oncol Hematol 2009;69(3):271-8.
[18]	Kwee TC, Basu S, Cheng G, Alavi A. FDG PET/CT in carcinoma of unknown primary. Eur J Nucl Med Mol Imaging 2010; 37(3): 635-44.
[19]	Translational research in oncology. In Desai PB (Ed). Practical clinical oncology. Jaypee Brothers Medical Publishers Ltd. New Delhi; 2014.
[20]	Varadhachary GR, Raber MN, Matamoros A, Abbruzzese JL. Carcinoma of unknown primary with a colon-cancer profile-changing paradigm and emerging definitions. Lancet Oncol 2008; 9(6): 596-9.
[21]	Dennis JL, Hvidsten TR, Wit EC, Komorowski J, Bell AK, Downie I, et al. Markers of adenocarcinoma characteristic of the site of origin: development of a diagnostic algorithm. Clin Cancer Res 2005; 11(10): 3766-72.
[22]	Oda E, Hashimoto D, Shiomi Y, Ohnishi K, Hayashi H, Chikamoto A, et al. A case of occult intrahepatic cholangiocarcinoma diagnosed by autopsy. Surgical Case Reports 2015; 1: 101.