Unknown Primary Head and Neck

82 yo woman who presents with a large L level Ib lymph node (4 cm, ENE, P16+/HPV-), staged as T0N3bM0. Imaging with CT neck and PET have been negative and no primary found. She has significant co-morbidities CAD, hx of PEs, COPD, etc which makes her a very poor surgical candidate. Ib node makes me think oropharynx or oral cavity primary. However, P16+/HPV- status suggests that this may be a cutaneous SCC instead? Given Ib, traditional volumes would be VERY large including entire oral... Read more
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Radiation Oncology Source Type: forums