BACKGROUND: We conducted a retrospective review of patients with unknown primary head and neck cancer who underwent a transoral laser microsurgery (TLM)-assisted search for an occult tumor. METHODS: Fifty-two patients at a single center with unknown primaries of squamous cell carcinoma (SCC) were treated with a surgical algorithm. RESULTS: The overall rate of primary tumor identification was 75% (39 of 52 patients). When selecting those cases in which a TLM algorithm with lingual tonsillectomy was utilized, the detection rate was 86% (31 of 36). Tumors were most commonly found in the lingual (65.0%) and palatine tonsils (27.5%). When directed biopsies did not locate a tumor, a higher yield was obtained with the addition of a lingual tonsillectomy in 8 patients. CONCLUSION: A surgical algorithm for the unknown primary that includes TLM-assisted techniques, including a lingual tonsillectomy, offers the greatest likelihood of successfully detecting the location of occult primary tumors.
BACKGROUND: We conducted a retrospective review of patients with unknown primary head and neck cancer who underwent a transoral laser microsurgery (TLM)-assisted search for an occult tumor. METHODS: Fifty-two patients at a single center with unknown primaries of squamous cell carcinoma (SCC) were treated with a surgical algorithm. RESULTS: The overall rate of primary tumor identification was 75% (39 of 52 patients). When selecting those cases in which a TLM algorithm with lingual tonsillectomy was utilized, the detection rate was 86% (31 of 36). Tumors were most commonly found in the lingual (65.0%) and palatine tonsils (27.5%). When directed biopsies did not locate a tumor, a higher yield was obtained with the addition of a lingual tonsillectomy in 8 patients. CONCLUSION: A surgical algorithm for the unknown primary that includes TLM-assisted techniques, including a lingual tonsillectomy, offers the greatest likelihood of successfully detecting the location of occult primary tumors.
Authors: J Kenneth Byrd; Kenneth J Smith; John R de Almeida; W Greer Albergotti; Kara S Davis; Seungwon W Kim; Jonas T Johnson; Robert L Ferris; Umamaheswar Duvvuri Journal: Otolaryngol Head Neck Surg Date: 2014-03-11 Impact factor: 3.497
Authors: Daniel G Deschler; Jeremy D Richmon; Samir S Khariwala; Robert L Ferris; Marilene B Wang Journal: Otolaryngol Head Neck Surg Date: 2014-06-12 Impact factor: 3.497
Authors: Timon Hussain; Elamprakash N Savariar; Julio A Diaz-Perez; Karen Messer; Minya Pu; Roger Y Tsien; Quyen T Nguyen Journal: Head Neck Date: 2015-06-22 Impact factor: 3.147