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Cancer of unknown primary: Cancer of unknown primary Expert commentary Madhumita Bhattacharyya Expert commentary Madhumita Bhattacharyya 

Cancer of unknown primary: Cancer of unknown primary Expert commentary Madhumita Bhattacharyya Expert commentary Madhumita Bhattacharyya
Chapter:
Cancer of unknown primary: Expert commentary Madhumita Bhattacharyya
Author(s):

Anna C Olsson-Brown

DOI:
10.1093/med/9780199688883.003.0025
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date: 31 October 2020

Cancer of unknown primary origin (CUP) is classically associated with rapid progression and poor prognosis. If review of the available radiological and pathological information favours a particular tumour type, site-specific chemotherapy can be instituted; otherwise, empirical combination chemotherapy is recommended. Many patients present with advanced disease and poor performance status. The introduction of dedicated multidisciplinary team (MDT) care for CUP, including an MDT with palliative care and oncology input, is designed to diagnose patients earlier and identify patients suitable for treatment earlier in their disease pathway. Furthermore, developments in imaging, immunohistochemistry, and molecular profiling may lead to improvements in identifying the site of origin or targets suitable for treatment. This is a case of a patient who presented with a raised CA125 and multiple liver metastases and responded to chemotherapy regimens with activity in ovarian cancer. Although an unusual case of CUP, the principles of diagnosis and management of CUP are well illustrated.

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