Abstract
Head and neck squamous cell cancers (HNSCC) arising from an unknown primary (UP) site are a challenging clinical entity. Although human papillomavirus (HPV) detection can localize a tumor to the oropharynx (OP), clinical and histologic confirmation can remain elusive in up to 60% of UPs of HNSCC. Traditional imaging modalities (computed tomography, magnetic resonance imaging) and operative approaches (exam under anesthesia [EUA], direct laryngoscopy [DL], biopsies) have had limited success in the identification of UPs.
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