Cancer of Unknown Primary

Cancer of Unknown Primary

Cancer Unknown Primary

Which staining is relatively specific for angiosarcoma?

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Factor VIII related antigen

Cancer Unknown Primary
Cancer Unknown Primary

Which staining would be suspicious for melanoma?

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S100, HMB-45 Ag, Vimentin

Cancer Unknown Primary
Cancer Unknown Primary

Which serum tumor markers can help identify poorly differentiated carcinoma of unknown primary?

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CEA, CA–125, CA 19–9, CA 15–3 – with limitations

Cancer Unknown Primary
Cancer Unknown Primary

What empiric chemotherapy options are available for poorly differentiated carcinomas of unknown primary with no primary site
identified?

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Paclitaxel and carboplatin , gemcitabine plus carboplatin , gemcitabine plus irinotecan

Cancer Unknown Primary
Cancer Unknown Primary

What cytogenetic abnormality would be suggestive of germ cell tumor?

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i12p

Cancer Unknown Primary
Cancer Unknown Primary

Which staining pattern would be suspicious for GIST?

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c-KIT

Cancer Unknown Primary
Cancer Unknown Primary

What diagnostic molecular tests can be ordered for cancer of unknown primary?

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Next generation sequencing, mismatch repair deficiencies, PD–L1 staining, Her2 staining,
microsatellite instability testing

Cancer Unknown Primary
Cancer Unknown Primary

Which stains would help suggest neuroendocrine carcinoma in a CUP?

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Chromogranin, synaptophysin

Cancer Unknown Primary
Cancer Unknown Primary

What is the clinical course of a NUT midline tumor?

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Very aggressive

Cancer Unknown Primary
Cancer Unknown Primary

For young man presenting with midline tumors, which tumor markers should be checked?

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Beta hCG and alpha-fetoprotein

Cancer Unknown Primary
Cancer Unknown Primary

What stains would help suggest adenocarcinoma of the lung?

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TTF1, napsin, CK7

Cancer Unknown Primary
Cancer Unknown Primary

Which stains would help suggest a germ cell tumor in men?

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HCG, alpha-fetoprotein, OCT4 transcription factor, placental alkaline phosphatase

Cancer Unknown Primary
Cancer Unknown Primary

Which stains would help suggest small cell carcinoma?

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TTF–1, high proliferative index, chromogranin

Cancer Unknown Primary
Cancer Unknown Primary

How would you treat a female patient with peritoneal carcinomatosis without an obvious primary ?

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Treat as ovarian cancer

Cancer Unknown Primary
Cancer Unknown Primary

Which stains are generally positive and negative in carcinomas?

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Positive Pankeratin, AE1/3, CAM 5.2, OSCAR, EMA
Negative CD45

Cancer Unknown Primary
Cancer Unknown Primary

What IHC staining pattern is most consistent with adenocarcinoma of the colon?

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CK20+ CDX2+ and CK7 –

Cancer Unknown Primary
Cancer Unknown Primary

How would you treat a female patient with isolated axillary adenocarcinoma?

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Treat it like an early stage breast cancer

Cancer Unknown Primary
Cancer Unknown Primary

What stains would suggest an RCC primary in CUP ?

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Pan keratin, CAM 5.2, PAX8, CK7, Vimentin

Cancer Unknown Primary
Cancer Unknown Primary

What are the 4 common histologic categories of epithelial (non-mesenchymal, lymphoid or myeloid) CUP ?

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Poorly differentiated carcinoma, neuroendocrine carcinoma, squamous cell, adenocarcinoma

Cancer Unknown Primary
Cancer Unknown Primary

What percentage of new malignancies are cancers of unknown primary?

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5%

Cancer Unknown Primary
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