The Occult Primary Tumor

Management of Cervical Metastases with Occult Primary

“…Smith et al (1967) noted a 62 % death rate within 6 months. The 5-year survival rate was found to be only 15 % in a series of 106 patients, reported by Winegar and Griffin (1973) The gradewise breakup in our series reveals that two cases out of four anaplastic carcinomas are still alive, all five cases of moderately differentiated carcinomas are dead, and only one out of three well-differentiated epidermoid carcinoma cases is alive. It will not be equivocal to suggest that the anaplastic carcinomas responded better than other grades of malignancy in our series.…”

“…France and Lucos (1963) obtained a longer survival in both squamous and undifferentiated carcinoma by radiation alone rather than a combination of radiotherapy and neck dissections. However, Winegar and Griffin (1973) reported that only 6.9 % of their patients had a 5-year cure rate with radiotherapy alone. Even with a limited follow-up of 8 months, our case No.…”

“…A small undetected primary may well have been included in the beam of radiation, getting cured and thus escaping dis covery. Winegar and Griffin (1973) postulated that the primary lesion might be so small that it was not discovered, or spontaneous regression had taken place. Any one or a combination of these possibilities could be the reason of primary remaining occult in our series also.…”

Incidence of occult primary—their diagnosis and non surgical management

“…One third of such patients also have additional symptoms including pain, weight loss, malaise, fatigue but less than 20% of these patients present in the early stage of disease due to lack of significance given to these symptoms. According to Winegar and Griffen (1973) average time of presentation from first sign of mass appearance in the neck was 5.1 months. The size of swelling indicates the prognosis e.g.…”

Incidence of occult primary-their diagnosis and surgical management

“…One third of such patients also have additional symptoms including pain, weight loss, malaise, fatigue but less than 20% of these patients present in the early stage of disease due to lack of significance given to these symptoms. According to Winegar and Griffen (1973) average time of presentation from first sign of mass appearance in the neck was 5.1 months. The size of swelling indicates the prognosis eg.…”