Metastatic squamous neck cancer with occult primary involves the spread of squamous cell cancer that originates in an unknown part of the body (referred to as occult primary or unknown origin) to lymph nodes in the neck or the area of the collarbone.
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Tests and exams performed to detect and diagnose metastatic squamous neck cancer with occult primary may include:
- Physical exam
- Fine needle aspiration (FNA) biopsy, in which a thin, hollow needle is used to remove tissue for testing to determine the cause of an enlarged lymph node in the neck and whether an endoscopic biopsy will be required as part of the diagnosis.
- Core needle biopsy that involves the removal of a tissue sample using a wider needle than is used for a fine needle aspiration (FNA) biopsy.
- Excisional biopsy, in which doctors remove an entire tumor or abnormal growth.
- Tonsillectomy, in which the tonsils are removed.
- Endoscopy where a physician uses an endoscope with a tiny camera attached to the end. The long, thin tube is inserted into a patient who is sedated during the procedure.
- Computed tomography (CT) scan that can help physicians to determine a tumor’s size and extent. CT scans combine multiple digital images of soft tissues and organs inside the body to provide a more detailed picture than a standard X-ray.
- Magnetic resonance imaging (MRI) scan that uses radio waves and magnets instead of X-rays to provide detailed pictures of the body’s soft tissues and organs.
- Positron emission tomography (PET) scan that includes an injection of radioactive sugar into the blood, then a digital imaging exam to determine if cancer cells are present. A PET scan is typically performed in conjunction with a CT scan.
Treatment options may include:
- Radical neck dissection that involves removal of the lymph nodes, as well as nearby muscles, nerves, blood vessels and usually the salivary gland.
- Modified radical neck dissection that is the removal of lymph nodes with the aim of sparing muscles, nerves and blood vessels.
- Partial (or selective) radical neck dissection that is the removal of a portion of lymph nodes with the goal of sparing muscles, nerves and blood vessels.
- 3-D conformal radiation, which allows visualizing a patient’s anatomy in three dimensions through the use of computer software and matching the amount of radiation to the shape of the tumor.
- Intensity-modulated radiation therapy (IMRT), which is an advanced form of 3-D conformal radiotherapy that allows the team to specify the dose of radiation for the tumor while restricting the dose to surrounding tissues.
Chemotherapy for metastatic squamous neck cancer with occult primary may be part of a treatment plan for aggressive forms of the disease when surgery is not an option and it can be used alone or in combination with radiation therapy.
To enhance the care of people dealing with metastatic squamous neck cancer with occult primary, Scripps Health also offers patient support services.