Abstract
Between January 1992 and January 2002, we treated 12 patients with metastatic carcinoma in cervical lymph nodes from an unknown primary tumor. Of 12 patients, the histological diagnosis was squamous cell carcinoma in 10 and adenocarcinoma in 2. Three patients were in clinical stage N3, 8 patients were in N2 and 1 patient was in N1. Among them, 6 patients with resectable lymph nodes were treated mainly with surgery, and 6 patients with unresectable lymph nodes or distant metastasis were treated with radiotherapy and/or chemotherapy. After these treatments, a primary lesion appeared in only one patient, who was diagnosed as having nasopharyngeal carcinoma. The loco-regional control rate in all patients was 75%. The control rate in the patients treated with surgery was 100%, and that in patients treated with radiotherapy and/or chemotherapy was 50%. Distant metastasis after treatment appeared more often in open-biopsy cases than in those receiving fine-needle aspiration (FNA) or open-biopsy with simultaneous radical neck dissection.According to these results, radical neck dissection appeared to be effective in controlling neck disease. For initial pathological diagnosis, FNA is recommended, while open biopsy should be avoided, if possible.
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