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Cancer of Unknown Primary Site


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The pathology report came back as non-cancerous on my mom's lung mass. They are calling it cups. Has anyone heard of this. They still want to diagnose it as Stage IV Lung Cancer because the axillary lymph node mass was cancerous and they cannot deny nor confirm that it is lung cancer? They said that the stains on the pathology report from the lymph node lead to lung cancer. I don't know what to do. Can anyone recommend a doctor for a second opinion in Pittsburgh, PA. We are currently going through UPMC Cancer Center.

Thanks,

Chrissy

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Can they send the lymph node slides out for another opinion? We had to send my dad's out to mayo and then to Baylor because the recurrence of melanoma had some characteristics of melanoma and sarcoma, and while it did take a while, it necessary as treatment was different for each, as was prognosis.

I can't say I know who is the leading pathologist in lucg cancer. Maybe someone else here can help you.

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http://www.cancer.gov/cancertopics/fact ... ownprimary

There is a marker called TTF-1 that is supposed to be accurate in determining if it is lung cancer.

There are other markers described in the next link. They are supposed to be 88% accurate

Ohio State also has a NCI designated center. James cancer center

http://www3.interscience.wiley.com/cgi- ... 1&SRETRY=0

the armed forces of pathology is supposed to have some of the best pathologist

http://www.afip.org/leadership.html

This is a reach, but could the tissue samples been mixed up?

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Looking at the report it does say the following...

This is for the biopsy of the Axillary Lymph Node.

the neoplasm is strongly positive for cytokeratin 7 and TTF-1, and shows patchy faint staining for cytokeratin 20. Gross cystic disease fluid protein immunohistochemical stain is negative. The results of morphology combined with immunohistochemistry favor a primary lung orgin of this neoplasm.

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Good luck with a 2nd opinion.

It does seem encouraging that the lung came back as non-cancerous.

From what I have read (I am not a Dr nor in the medical field), the TTF-1 is a good indicator.

The Drs are treating it like it is stage IV because it is systemic.

I don't necessarily know, but the prognosis seems like it might be better than IV.

You might also want to check out clinical trials if you Mom is open to that idea

Has a pet scan been done to look for Mets in other parts of the body?

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According to oncodoc, a former poster and expert here, his opinion was a pathologist at the Mayo Clinic in Rochester, MN. Apparently, slides are sent to him especially for questionable, difficult to diagnose lung cancers. Supposedly, he is world-renowned in the path. community as the expert.

Cindi o'h

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My mom has had an xray after the surgeries and nothing showed up. She has another Pet scan schedule on 11/13 and a follow up Oncologist appt. the week after to determine what to do next. The Oncologist has pretty much said that they are confused. They are relabeling my mom as Metastatic Adenocarcinoma with CUPS (Cancer of uncertain primary site) with it being a possiblity of Lung Cancer. The whole thing is just soooooo frustrating. Does anyone know if there are certain areas of the body that Cancer can hide or just not show up on the Pets scan?

Thanks,

Chrissy

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Didn't have time to read this.

But there might be something in there

http://www.minervamedica.it/pdf/R39Y200 ... 2A0164.pdf

I think for lymph nodes in the lung PET is about 85% accurate

There is also a combined CT/PET scan machine. Probably could not be used before an area is identified

There are extremely rare cases of spontaneous remission in lung cancer. I am sure the Drs will still activiely try to find mets and or do chemo, but I read it has happedn

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Thank you John. It's been hard for me to find much on CUPS. It's been very frustrating for my family not knowing and understanding this. I could use anyone's insight on my Mom's situation. The only tumor that has been found is the Axillary lymph node in the armpit. That is the only site where cancer has been detected. The doctor wants to treat it with Chemo like Lung Cancer. I am nervous about this because they are not sure it is lung cancer. They are only going on the Pathology results which suggest lung cancer. We have a second opinion scheduled for Nov. 1st and hopefully they will have some more information maybe something that her current oncologist missed.

Thanks,

Chrissy

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http://www2.umdnj.edu/pathpweb/intersti ... brosis.htm He is out of the Mayo Clinic in Arizona.

I heard slides could be sent to Mayo clinic. They could get to the root of it there.

I asked online for anyone who knew this. Andrea answered me as they did tht with her dad.

She gave me the link above.

Maryanne

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Chrissy..

Just a side note. If you still aren't happy with Pittsburgh cancer center please consider Fox Chase in Philly.

I'm also from PA and I was sent to geisinger. I was given a 2nd opinion but it had to be at geisinger. I wanted a truely objective opinion from another institution. Finally, after many treatments, phone calls etc. I was permitted to go to fox chase. They were wonderful did the surgery that removed my tumor. I would recommend them if you don't get the results you want from you 2nd opinion.

Just a thought.. good luck! tami

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