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Laryngorhinootologie 2024; 103(05): 371-382
DOI: 10.1055/a-2150-4834
CME-Fortbildung

Zervikales CUP-Syndrom: Diagnostik und Therapie

Cervical CUP Syndrome: Diagnosis and Therapy
Anne Lammert
,
Yasser Abo-Madyan
,
Lena Huber
,
Sonja Ludwig
,
Claudia Scherl
,
Nicole Rotter
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Beim zervikalen CUP-Syndrom liegt eine histologisch gesicherte Halslymphknotenmetastase bei unbekanntem Primärtumor vor. Die Diagnostik beinhaltet neben Anamnese, klinischer Untersuchung und histologischer Sicherung die radiologische Bildgebung mittels PET/CT sowie eine Panendoskopie mit histologischer Primärtumorsuche. Als Behandlungsoptionen stehen eine chirurgische Therapie mit Neck Dissection und die Radiochemotherapie zur Verfügung.

Abstract

In CUP syndrome (CUP = cancer of unknown primary) there are 1 or more metastases of a primary tumor that cannot be localized despite extensive diagnostics. CUP syndrome accounts for 5% of all human malignancies, making it one of the 10 most common forms of cancer. In addition to inflammatory lymph node enlargement and benign changes such as cervical cysts, lymph node metastases are among the most common cervical masses. Cervical CUP syndrome is a histologically confirmed cervical lymph node metastasis with an unknown primary tumor. In addition to anamnesis, clinical examination and histological confirmation, diagnostics include radiological imaging using PET-CT and panendoscopy with histological primary tumor search. Treatment options include surgical therapy with neck dissection and chemoradiotherapy.

Kernaussagen

  • Die Pathogenese des zervikalen CUP-Syndroms bleibt ungeklärt; es werden unterschiedliche Theorien der Genese diskutiert, wodurch sich jedoch kein Einfluss auf Diagnostik und Therapie ergibt.

  • Die Lage der Halslymphknotenmetastase und des HPV-Status lassen Rückschlüsse auf die mögliche Lage des Primärtumors zu.

  • Die PET/CT sollte nach Möglichkeit frühzeitig in der Diagnostik des zervikalen CUP-Syndroms eingesetzt werden, da sich die Chance zur Identifikation des Primärtumors dadurch verbessert. Die Frage der Kostenübernahme stellt im klinischen Alltag eine Hürde dar.

  • Eine multimodale Therapie in mehreren Schritten, bestehend aus Chirurgie und anschließender Radio(chemo)therapie, ist einer der wichtigsten Faktoren für die Verbesserung des Outcomes der Betroffenen.

Schlüsselwörter

Kopf-Hals-Tumore - Metastase - CUP-Syndrom - Primärtumorsuche - Neck Dissection - Bestrahlung - Radiochemotherapie

Keywords

Head neck tumors - metastasis - CUP-Syndrom - cancer of unknown primary - neck dissection - chemoradiotherapy


Publication History

Article published online:
02 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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