Metastatic squamous neck cancer with occult primary is a disease in which squamous cell
cancer spreads to lymph nodes in the neck and not known where the cancer first
formed in the body.
Squamous cells are thin, flat cells found in tissues that form the surface layer of the skin and body cavities like the mouth, hollow organs like the uterus and blood vessels, and lining the respiratory (breathing) and digestive tract. Some organs with squamous cells are the esophagus, lung, kidney, and uterus. Cancer can begin in the squamous cells anywhere in the body and metastasize (spread) through the blood or lymph system to other parts of the body.
When squamous cells cancer spreads to lymph nodes in the neck or around the collarbone, it is called metastatic squamous neck cancer. The doctor will try to find the primary tumor (cancer that first formed in the body), as treatment for metastatic cancer is the same as treatment for primary tumors. For example, when lung cancer spreads to the neck, the cancer cells in the neck are lung cancer cells and those treated with lung cancer. Sometimes doctors can not find where in the body the cancer first starts to grow. When the test can not find the primary tumor, it is called the tumor (hidden) occult primary. In many cases, the primary tumor was never found.
Possible signs of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat.
A doctor should be seen whether there is a lump or pain in the neck or throat that does not go away. These and other symptoms may be caused by cancer metastatic squamous neck with occult primary. Other conditions can cause similar symptoms.
Tests that examine the tissues of the neck, respiratory tract, and upper part of the digestive tract that is used to detect (find) and diagnose metastatic squamous neck cancer and primary tumor.
The test will include an examination for the primary tumor in the organs and tissues of the respiratory tract, upper digestive tract (including the lips, mouth, tongue, nose, throat, vocal cords, and part of the esophagus and trachea), and genitourinary systems. The following procedure may be used:
• Physical examination and history: An exam of the body, especially the head and neck, to check general signs of health. These include checking for signs of disease, such as lumps or anything else that seems unusual. History of the patient's health habits and past illnesses and treatments will also be taken.
• Endoscopy: A procedure to look at organs and tissues in the body to check for abnormal areas. An endoscope is inserted through an incision (cut) in the skin or opening in the body, such as the mouth or nose. Endoscopy is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, were examined under a microscope for signs of disease. The larynx, pharynx, esophagus, trachea, and bronchi will be checked.
• Biopsy: removal of cells or tissues so they can be viewed under a microscope by a pathologist or tested in the laboratory to check for signs cancer. Two types of biopsies may be performed:
o Fine-needle aspiration (FNA) biopsy: Removal tissue or fluid using a thin needle.
o Biopsy excision: Removal of a lump the entire network.
• Sinus x-ray: An x-ray of the sinuses (head space). X-ray is a type of energy beam that can pass through the body onto film, making pictures of areas inside the body. Biopsies can be taken.
• Chest X-ray: An x-ray of the organs and bones inside the chest. X-ray is a type of energy beam that can pass through the body and onto film, making pictures of areas inside the body.
• Bronchoscopy: A procedure to look inside the trachea and large airways in the lungs for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. Bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, were examined under a microscope for signs cancer.
• MRI (Magnetic Resonance Imaging): A procedure that uses a magnet, radio waves and computers to create a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. PET scanner rotates around the body and create a picture of where glucose is used in the body. Malignant tumor cells appear brighter in the picture because they are more active and take more glucose than normal cells.
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The images created by computers connected to the x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• Tumor marker serum test: A procedure in which a blood sample is checked to measure the amount of certain substances released into the blood by organs, tissues, or tumor cells in the body. Specific substances associated with certain types of cancer when found in increased levels in the blood. These are called tumor markers. The test will be performed to detect the following tumor markers:
o Alpha-fetoprotein (AFP).
o Beta-human chorionic gonadotropin (β-hCG).
A diagnosis of occult primary tumor is made if the primary tumor was not found during testing or treatment.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
• The number and size of lymph nodes that have cancer in them.• Whether the cancer has responded to treatment or has recurred (come back).
• How different from normal the cancer cells look under a microscope.
• The patient's age and general health.
Treatment options also depend on the following:
• What part of the incoming neck cancer
• Whether certain tumor markers are found.
