Zervikales CUP-Syndrom: Diagnostik und Therapie

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.

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 der 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

Publikationsverlauf

Artikel online veröffentlicht:
26. Februar 2025

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