Computed Tomographic Assessment of Squamous Cell Carcinoma-Reply

Abstract

In Reply .—The question raised regarding the accuracy of either CT or random biopsies in 20 patients who were initially seen with unknown primary malignant neoplasms and clinical cervical adenopathy. Of these 20 patients, the primary site was identified in 15 instances. In one patient with extensive nasopharyngeal carcinoma it was identified by CT scan; the initial biopsy result was normal. In another patient, the CT scan was normal and, on panendoscopy, a positive biopsy specimen was obtained from a superficial lesion of the piriform sinus. In two other patients, the CT scan showed a submucosal lesion at the piriform sinus that we were unable to confirm by repeated panendoscopy. Three patients with inapparent tumors at the tonsil on CT scan and physical examination had positive random biopsy specimens at this site for squamous cell carcinoma. The remaining eight patients had tumors which were identified at CT and confirmed