Metastatic cervical adenocarcinoma from unknown primary tumor. Treatment dilemma

Adenocarcinomas with cervical metastases as their only manifestation are infrequent. They have been grouped with metastatic squamous carcinomas of unknown primary tumor in the ear, nose, and throat literature. Most cases represent distant metastases and will have a rapid downhill course to death despite all treatment. A diligent search should be made for treatable adenocarcinomas, eg, breast, ovary, prostate, and thyroid. The primary site will be found in only a small minority of cases by any means. Radical neck dissection should not be performed when the primary tumor is not localized to the head and neck.