CC BY-NC-ND 4.0 · Laryngorhinootologie 2021; 100(S 02): S119-S120
DOI: 10.1055/s-0041-1727954
Abstracts
Head-Neck-Oncology: Multimodal / Interdisciplinary

Cervical CUP adenocarcinoma syndrome as an interdisciplinary challenge with ten specialist disciplines

E Seiz
1   Universitätsklinikum Mannheim, Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Mannheim
,
N Rotter
1   Universitätsklinikum Mannheim, Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Mannheim
,
P Hohenberger
2   Universitätsklinikum Mannheim, Spezielle chirurgische Onkologie und Thoraxchirurgie, Mannheim
,
M Keese
3   Universitätsklinikum Mannheim, Gefäßchirurgie, Mannheim
,
C Faymonville
4   Universitätsklinikum Mannheim, Orthopädie und Unfallchirurgie, Mannheim
,
U Kneser
5   BG Klinik Ludwigshafen, Klinik für Hand-, Plastische- und Rekonstruktive Chirurgie, Mikrochirurgie, Ludwigshafen
,
C Scharff
6   Universitätsklinikum Mannheim, Pathologisches Institut, Mannheim
,
S Schönberg
7   Universitätsklinikum Mannheim, Klinik für Radiologie und Nuklearmedizin, Mannheim
,
Ramon de Juan Rubio
7   Universitätsklinikum Mannheim, Klinik für Radiologie und Nuklearmedizin, Mannheim
,
S Weingärtner
8   Universitätsklinikum Mannheim, Klinik für Hämatologie und Onkologie, Mannheim
,
Jürgen Meinhardt
9   Universitätsklinikum Mannheim, Klinik für Anästhesiologie und Operative Intensivmedizin, Mannheim
,
C Scherl
1   Universitätsklinikum Mannheim, Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Mannheim
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    Introduction Compared to squamous cell carcinoma (SCC), cervical CUP adenocarcinomas (ADC) usually have a caudal cervical position and a poorer prognosis. We present a case whose diagnostics and therapy involved ten specialist disciplines (SD).

    Case A 64-year-old patient presented with a neck metastasis on the right site. The clinical examination (SD 1 ENT) and an MRI showed a cystic tumor that reached from level II to the upper thoracic aperture. After panendoscopy and punch biopsy, PET-CT (SD 2 Nuclear Medicine) was performed without any primary tumor evidence. A CT-guided punch biopsy was performed (SD 3 radiology), which resulted in an SCC with a differential diagnosis of an ADC (SD 4 pathology). According to the tumor board, the patient received a pharyngeal CUP procedure and a neck dissection on the right as well as resection of the superior sulcus, including pleura by ENT and thoracic surgery (SD 5). Because of an infiltrated subclavian vein and exposed subclavian artery, a temporary claviculotomy, resection of the subclavian vein, and patch surgery of the subclavian artery had to be performed (SD 6,7,8 orthopedics, vascular surgery, anesthesia). The final histological findings showed a G3 ADC. Secondly, due to impaired wound healing in the superior sulcus, the defect was covered with an ALT flap (SD 9 plastic surgery). Due to the long course, no definitive chemoradiotherapy took place. Eight months later, a mediastinal relapse occurred, treated palliatively with carboplatin and paclitaxel (SD 10 hemato-oncology).

    Conclusion The present case shows a complicated course that could only be managed in an interdisciplinary manner. The cervical ADC treatment should primarily be carried out on an interdisciplinary basis because of the aggressive caudal spreading behavior.

    Poster-PDF A-1593.pdf


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    Conflict of interest

    Der Erstautor gibt keinen Interessenskonflikt an.

    Address for correspondence

    Dr. med. Seiz Elena
    Universitätsklinikum Mannheim, Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie
    Friedrich-Karl-Str. 4
    68165 Mannheim

    Publication History

    Article published online:
    13 May 2021

    © 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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