Page 11 - Head and neck surgery

(II) METASTATIC SQUAMOUS CELL

CARCINOMA OF UNKNOWN PRIMARY

(SCCUP)

Metastatic SCCUP accounts for ~4% of all head and neck tumours.

By definition the primary tumour cannot be identified on clinical and

radiological examination:

• Clinical examination

• Endoscopic examination using routine white light, narrow band
imaging and lugol’s chromoendoscopy

• Imaging with MRI and whole-body PET-CT scan

Conventionally patients would then be subjected to examination of
the oral cavity and oropharynx under general anaesthesia. If no

abnormality can be seen or palpated, tonsillectomy and random
tongue base biopsy would be performed as a last resort to identify

the primary.