Carcinoma of unknown primary (CUP-syndrome): Metastases of unknown primary tumor [Carcinoma of unknown primary (CUP-Syndrom): Metastasen eines unbekannten primärtumors]

The diagnosis of cancer is not necessarily linked to the identification of the primary malignancy. Clinicians treating patients with carcinoma of unknown primary (CUP) are often facing diagnostic and therapeutic difficulties. Foremost, there is no generally accepted definition of CUP-syndromes. One of the most striking features of this type of cancer is an atypical pattern of metastases associated with an unusual growth behavior. After detection of metastatic disease without a corresponding primary tumor, limited diagnostic effort should focus on potential therapeutic strategies. First of all, potentially curative tumor types (e. g. extragonadal germ cell cancer, atypical malignant lymphoma), or at least potentially chemo-sensitive cancers should be recognized and adequately treated. Otherwise, various treatment options like surgery, radiotherapy and other medical strategies should be considered. However, the vast majority of patients with CUP-syndrome have a poor prognosis with a median survival time of 3-11 months. Population-based analyses showed that only 15% of all patients with CUP-syndrome survive the first year after diagnosis. © 2007 Springer Medizin Verlag.