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Open Access 03-07-2023 | Cancer of Unknown Primary | NON-THEMATIC REVIEW

Carcinoma of unknown primary (CUP): an update for histopathologists

Authors: Katie Beauchamp, Bruce Moran, Timothy O’Brien, Donal Brennan, John Crown, Kieran Sheahan, Maura Bríd Cotter

Published in: Cancer and Metastasis Reviews | Issue 4/2023

Abstract

Carcinoma of unknown primary (CUP) is a heterogeneous group of metastatic cancers in which the site of origin is not identifiable. These carcinomas have a poor outcome due to their late presentation with metastatic disease, difficulty in identifying the origin and delay in treatment. The aim of the pathologist is to broadly classify and subtype the cancer and, where possible, to confirm the likely primary site as this information best predicts patient outcome and guides treatment. In this review, we provide histopathologists with diagnostic practice points which contribute to identifying the primary origin in such cases. We present the current clinical evaluation and management from the point of view of the oncologist. We discuss the role of the pathologist in the diagnostic pathway including the control of pre-analytical conditions, assessment of sample adequacy, diagnosis of cancer including diagnostic pitfalls, and evaluation of prognostic and predictive markers. An integrated diagnostic report is ideal in cases of CUP, with results discussed at a forum such as a molecular tumour board and matched with targeted treatment. This highly specialized evolving area ultimately leads to personalized oncology and potentially improved outcomes for patients.

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Title: Carcinoma of unknown primary (CUP): an update for histopathologists
Authors: Katie Beauchamp
Bruce Moran
Timothy O’Brien
Donal Brennan
John Crown
Kieran Sheahan
Maura Bríd Cotter
Publication date: 03-07-2023
Publisher: Springer US
Keywords: Cancer of Unknown Primary
Pathology
Published in: Cancer and Metastasis Reviews / Issue 4/2023
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI: https://doi.org/10.1007/s10555-023-10101-6

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