A mini review on cancer of unknown primary site: A clinical puzzle for the oncologists

Cancer of unknown primary (CUP) is a well recognized clinical syndrome, accounting for 3-5% of all malignancies. It is characterized as a disease with an early dissemination of metastases without a primary detected site after extensive laboratory and clinical investigations. CUP is divided into the favorable and unfavorable groups based on histopathological and clinical manifestations. Adenocarcinoma of various differentiations is the commonest histopathological subtype. Favorable groups are treated with local or systemic treatment and some of them are enjoying long-term survival. On the contrary, unfavorable groups are treated with empirical chemotherapy having usually a dismal prognosis. Gene-profiling microarray diagnosis has a high diagnostic sensitivity, but its predictive or prognostic value remains uncertain.