TY - CHAP M1 - Book, Section TI - Carcinoma of Unknown Primary A1 - Varadhachary, Gauri R. A2 - Kantarjian, Hagop M. A2 - Wolff, Robert A. PY - 2016 T2 - The MD Anderson Manual of Medical Oncology, 3e AB - Carcinomas of unknown primary (CUPs), with their heterogeneous presentations, pose a challenge on the diagnostic and therapeutic fronts. Depending on the extent of evaluation, CUP comprises 3% to 5% of all tumors diagnosed (1,2,3). A working definition for CUP is biopsy-proven metastatic cancer with no identifiable primary source by history; physical examination; chest radiography; complete blood cell count; chemistry; computed tomography (CT) of the chest, abdomen and pelvis; prostate-specific antigen (PSA) in men; and mammography in women (2). The natural history of disease for CUP is diverse and is dependent on multiple variables, such as, age, number of metastatic sites, dominant area of disease, and histology. This considerable heterogeneity presents a challenge to the systematic study of CUPs. In addition, the emergence of sophisticated imaging, robust immunohistochemistry (IHC), and genomic and proteomic tools have challenged the “unknown” designation. Depending on histologic features, sites of disease, and performance status, a small but significant minority of patients will be long-term survivors, and it is important to identify these groups of patients (4,5). SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1126745640 ER -