AM report teaching points from today... with some help from many #formerchiefs!
1) CUP can be a diagnostic puzzle. @NCCN guidelines are an amazing place to start. Prioritize biopsying an accessible lesion, and stratify from there. [1/5].
1) CUP can be a diagnostic puzzle. @NCCN guidelines are an amazing place to start. Prioritize biopsying an accessible lesion, and stratify from there. [1/5].
2) Some culprits include lymphoma, melanoma, sarcoma, germ cell tumors, and NETs, among others. Adenocarcinoma or SCC without clear primary may be treated by a combination of platinum agent + another agent (such as carboplatin + paclitaxel). [2/5]
3) What about neuroendocrine tumors as a cause? Even advanced pancreatic NETs may respond to capecitabine + temozolomide per work by @PamelaKunzMD. #formerchiefs ascopubs.org/doi/10.1200/JC… [3/5]
4) From @EvanHallMD: patients with CUP don't fit neatly into categories and thus can struggle with being shunted between clinics. It's critical to be mindful of this added burden both medically and emotionally. #formerchiefs [4/5]
5) Bonus pearl from @tpjmd: NETs can present almost anywhere and have overlapping features on pathology with adenocarcinomas. However if clinically the syndrome suggests a tumor secreting active hormone - this suggests a NET. #formerchiefs [5/5]
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