Carcinoma of the Unknown Primary (CUPS) - Knowing the Unknown

Abstract

Introduction: Cancers of unknown primary site (CUPs) account for approximately 3% of all malignant neoplasms and it is the ninth commonest type of cancer. Indian data with CUPs comprises of very few publications except for isolated case reports. Methodology: Cross sectional study of 100 patients, reporting to a tertiary care centre was carried out.  Detailed history, examination and relevant investigations were done. Data tabulated and analysed for demographic and histopathological aspects. Results: The median age of presentation was 49 yrs in the patients who presented with nodal metastasis while in extra nodal disease the median age of presentation was 59 yrs. Majority of patients 40% c/o neck swelling, whereas 10% patients also had enlarged inguinal nodes Hepatomegaly was found in 17% of cases and splenomegaly in 9% patients. 28% of patients had peripheral lymphadenopathy. The most common histopathology was adenocarcinoma followed by poorly differentiated carcinoma. The liver, pleura and bone were the most commonly involved metastatic sites. Conclusion: The molecular tumor profiling is important for faster diagnosis and improved treatment options. However, till the time the newer modalities are validated and used in clinical practice, conventional diagnostic modalities and clinical examination remain to be the main stay.